Provider Demographics
NPI:1376601195
Name:HAYWARD, GERALD MEIBO (MD)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:MEIBO
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666
Mailing Address - Country:US
Mailing Address - Phone:410-992-4300
Mailing Address - Fax:410-992-9180
Practice Address - Street 1:405 FREDERICK RD STE 210
Practice Address - Street 2:#210
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4647
Practice Address - Country:US
Practice Address - Phone:410-992-4300
Practice Address - Fax:410-992-9180
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41836208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDS1851OtherMEDICARE RAILROAD - GROUP
MDP01003968OtherMEDICARE RAILROAD
DC026554500OtherMA
DCG01478G01OtherMCR INIVIDUAL
MDP00215480OtherMEDICARE RAILROAD
MDDS1851OtherMEDICARE RAILROAD - GROUP
MD748M303FMedicare PIN