Provider Demographics
NPI:1033133418
Name:HAYES, AVERY M (MD)
Entity Type:Individual
Prefix:MR
First Name:AVERY
Middle Name:M
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5000 W NATIONAL AVE
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53295-0001
Mailing Address - Country:US
Mailing Address - Phone:414-384-2000
Mailing Address - Fax:414-382-5351
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:414-382-5351
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI41413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34100800Medicaid
WI1033133418Medicaid
WI1033133418Medicaid
WI0017 73-601Medicare ID - Type UnspecifiedMILWAUKEE COUNTY