Provider Demographics
NPI:1154374387
Name:HAY, TAMMY L (DO)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:L
Last Name:HAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4014 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1017
Mailing Address - Country:US
Mailing Address - Phone:704-384-4098
Mailing Address - Fax:704-384-5143
Practice Address - Street 1:1918 RANDOLPH RD
Practice Address - Street 2:STE 275
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1100
Practice Address - Country:US
Practice Address - Phone:704-384-4098
Practice Address - Fax:704-384-5143
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-01391207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT00488Medicaid
NC89-11279Medicaid
SCT00488Medicaid
NC89-11279Medicaid