Provider Demographics
NPI:1639161185
Name:HAYES, ANNE B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:B
Last Name:HAYES
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 1:755 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7497
Mailing Address - Country:US
Mailing Address - Phone:717-273-6706
Mailing Address - Fax:717-273-1435
Practice Address - Street 1:755 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7497
Practice Address - Country:US
Practice Address - Phone:717-273-6706
Practice Address - Fax:717-273-1435
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054064L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015272200006Medicaid
784436OtherHIGHMARK BLUE SHIELD
02119901OtherCAPITAL BLUE CROSS
P003054OtherGATEWAY HEALTH PLAN
P003054OtherGATEWAY HEALTH PLAN
G09007Medicare UPIN