Provider Demographics
NPI:1285679365
Name:HAYWARD, DANIEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9625 RED ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106-9559
Mailing Address - Country:US
Mailing Address - Phone:269-465-5060
Mailing Address - Fax:
Practice Address - Street 1:9625 RED ARROW HWY
Practice Address - Street 2:
Practice Address - City:BRIDGMAN
Practice Address - State:MI
Practice Address - Zip Code:49106-9559
Practice Address - Country:US
Practice Address - Phone:269-465-6050
Practice Address - Fax:269-465-3134
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110089871OtherRAILROAD MEDICARE
MI1101100432OtherBLUE CROSS
MI2964857Medicaid
MI3516748OtherCIGNA
MI04-31139OtherPHP
MI04-31139OtherPHP
MIBH3310163OtherDEA
MIF67850Medicare UPIN