Provider Demographics
NPI:1437129285
Name:DARTEY-HAYFORD, SAMUEL KWAME (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:KWAME
Last Name:DARTEY-HAYFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-9900
Mailing Address - Fax:704-384-9919
Practice Address - Street 1:1900 RANDOLPH RD
Practice Address - Street 2:SUITE 580
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1122
Practice Address - Country:US
Practice Address - Phone:704-384-9900
Practice Address - Fax:704-384-9919
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT66419231205207RP1001X
NC201000974207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC1231Medicaid
NC5915862Medicaid
SCNC1231Medicaid
NC5915862Medicaid