Provider Demographics
NPI:1629039888
Name:HAWKINS, MICHELLE YVETTE (MD, MPM)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:YVETTE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD, MPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 HIGH ST APT 157
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2857
Mailing Address - Country:US
Mailing Address - Phone:234-678-9760
Mailing Address - Fax:
Practice Address - Street 1:2200 HIGH ST APT 157
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-2857
Practice Address - Country:US
Practice Address - Phone:234-678-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051504L207R00000X, 208D00000X
WV22727207R00000X
VA0101237577207R00000X
OH097727207R00000X
IN99107167A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F86631Medicare UPIN