Provider Demographics
NPI:1528086535
Name:HARRIS HAYWOOD, SONJIA (MD)
Entity type:Individual
Prefix:
First Name:SONJIA
Middle Name:
Last Name:HARRIS HAYWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-085434207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00377284OtherRAILROAD MEDICARE
OH7232301OtherAETNA
OHP00333104OtherRAILROAD MEDICARE
000000217241OtherUNISON
OH000000355163OtherANTHEM
OH000000530389OtherANTHEM
363614OtherWELLCARE
OH000000503552OtherANTHEM
OH363613OtherWELLCARE MEDICAID
737676OtherBUCKEYE
OH2542921Medicaid
OHP00377284OtherRAILROAD MEDICARE
363614OtherWELLCARE
OH000000503552OtherANTHEM
OH2542921Medicaid