Provider Demographics
NPI:1366766602
Name:HAJEC, MARYGRACE CHRISTINE (MD)
Entity type:Individual
Prefix:MRS
First Name:MARYGRACE
Middle Name:CHRISTINE
Last Name:HAJEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MARYGRACE
Other - Middle Name:CHRISTINE
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 980631
Mailing Address - Street 2:NS: NEUROSURGERY
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0631
Mailing Address - Country:US
Mailing Address - Phone:804-828-2437
Mailing Address - Fax:804-828-1953
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:NS: NEUROSURGERY
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-2437
Practice Address - Fax:804-828-1953
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53276-20207T00000X
VA390200000X
VA0101260349207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program