Provider Demographics
NPI:1992868764
Name:HAYAT, SUMERA (MD)
Entity type:Individual
Prefix:
First Name:SUMERA
Middle Name:
Last Name:HAYAT
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 1:2006 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4192
Mailing Address - Country:US
Mailing Address - Phone:559-324-9900
Mailing Address - Fax:
Practice Address - Street 1:2006 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4192
Practice Address - Country:US
Practice Address - Phone:559-324-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-00562207Q00000X, 207V00000X
CA54515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G74103Medicare ID - Type Unspecified
NC891155JMedicare ID - Type Unspecified
NC2258630AMedicare ID - Type Unspecified