Basic Information
| Provider Information | |||||||||
| NPI: | 1851459762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP | ||||||||
| Address2: | 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018166660 | ||||||||
| FaxNumber: | 3018166308 | ||||||||
| Practice Location | |||||||||
| Address1: | 8028 RITCHIE HIGHWAY | ||||||||
| Address2: | SUITE 134 | ||||||||
| City: | PASADENA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211221075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105532410 | ||||||||
| FaxNumber: | 4105532468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | D37014 | MD | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.