Provider Demographics
NPI:1467547158
Name:HAYES, DPM, ERNEST M (DPM)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:M
Last Name:HAYES, DPM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:LUBEC
Mailing Address - State:ME
Mailing Address - Zip Code:04652-0538
Mailing Address - Country:US
Mailing Address - Phone:207-733-2429
Mailing Address - Fax:207-733-2429
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-1201
Practice Address - Country:US
Practice Address - Phone:207-733-2429
Practice Address - Fax:207-733-2429
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD1002213E00000X, 213EP1101X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME017292OtherANTHEM BLUE CROSS BLUE SHIELD
ME194120000Medicaid
ME194120000Medicaid
MET11015Medicare UPIN