Provider Demographics
NPI:1306889605
Name:HAHALYAK, MICHAEL P (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:HAHALYAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7546 ROUTE 30
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-7528
Mailing Address - Country:US
Mailing Address - Phone:724-765-1030
Mailing Address - Fax:724-765-1023
Practice Address - Street 1:7546 ROUTE 30
Practice Address - Street 2:1ST FLOOR
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-7528
Practice Address - Country:US
Practice Address - Phone:724-765-1030
Practice Address - Fax:724-765-1023
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004995L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080172836OtherRAILROAD MEDICARE
204445OtherUPMC HEALTH PLAN
108575OtherBLUE SHIELD
P000251OtherGATEWAY HEALTH PLAN
4020810OtherAETNA
PA001079622Medicaid
P000251OtherGATEWAY HEALTH PLAN
PA108575NHMMedicare PIN