Provider Demographics
NPI:1063571370
Name:GERALD M HAYWARD MD PA
Entity type:Organization
Organization Name:GERALD M HAYWARD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:MEIBO
Authorized Official - Last Name:HAYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-992-4300
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-0999
Mailing Address - Country:US
Mailing Address - Phone:410-992-4300
Mailing Address - Fax:410-992-9180
Practice Address - Street 1:405 FREDERICK RD STE 210
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4647
Practice Address - Country:US
Practice Address - Phone:410-992-4300
Practice Address - Fax:410-992-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41836174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP01003968OtherMEDICARE RAILROAD-- (INDIVIDUAL)
MD156961900Medicaid
MD52334207OtherMARYLAND BCBS
DC026554500Medicaid
MDDS1851OtherMEDICARE RAILROAD-- (GROUP)
MDE94069Medicare UPIN
MDP01003968OtherMEDICARE RAILROAD-- (INDIVIDUAL)
DC026554500Medicaid