Provider Demographics
NPI:1316931058
Name:HAWES, MARY LINDA (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LINDA
Last Name:HAWES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:901 N WINSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-8467
Mailing Address - Country:US
Mailing Address - Phone:252-937-0200
Mailing Address - Fax:252-443-0096
Practice Address - Street 1:901 N WINSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8467
Practice Address - Country:US
Practice Address - Phone:252-937-0200
Practice Address - Fax:252-443-0096
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC25860207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3084745OtherCIGNA HEALTHCARE
NC110095565OtherRAILROAD MEDICARE
NC40558OtherBCBSNC
NC25112OtherMEDCOST
NC8940558Medicaid
NC207113Medicare PIN
NC25112OtherMEDCOST