Provider Demographics
NPI:1578890703
Name:HAYWARD, DOUGLAS W (ERYT)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:W
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:ERYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S ALLEN ST STE A
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4804
Mailing Address - Country:US
Mailing Address - Phone:610-780-9821
Mailing Address - Fax:
Practice Address - Street 1:220 S ALLEN ST STE A
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4804
Practice Address - Country:US
Practice Address - Phone:610-780-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator