Provider Demographics
NPI:1598780603
Name:HAYDEN, TREVIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:TREVIA
Middle Name:F
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5632 BROADMOOR TER N
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-9149
Mailing Address - Country:US
Mailing Address - Phone:301-865-4498
Mailing Address - Fax:301-846-0143
Practice Address - Street 1:97 THOMAS JOHNSON DR STE 102
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4379
Practice Address - Country:US
Practice Address - Phone:301-846-0434
Practice Address - Fax:301-846-0143
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00530962084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD973D814LMedicare ID - Type Unspecified
MDG75632Medicare UPIN