Provider Demographics
NPI:1124031299
Name:HAYS M.D., FREDERICK W
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:HAYS M.D.
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742
Mailing Address - Country:US
Mailing Address - Phone:978-369-5677
Mailing Address - Fax:978-371-1673
Practice Address - Street 1:290 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742
Practice Address - Country:US
Practice Address - Phone:978-369-5677
Practice Address - Fax:978-371-1673
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA29665208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB14042OtherBLUE CROSS BLUE SHIELD
MAP00094311OtherRAILROAD MEDICARE
MAGX0092Medicare PIN
MAGX0092Medicare UPIN
MAB14042OtherBLUE CROSS BLUE SHIELD