Provider Demographics
NPI:1922062348
Name:HAYWARD, CHRISTOPHER B (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 NATHAN LN
Mailing Address - Street 2:
Mailing Address - City:BARING PLT
Mailing Address - State:ME
Mailing Address - Zip Code:04694-5051
Mailing Address - Country:US
Mailing Address - Phone:207-454-3816
Mailing Address - Fax:
Practice Address - Street 1:10 PALMER ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1386
Practice Address - Country:US
Practice Address - Phone:207-454-8432
Practice Address - Fax:207-454-8333
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1484208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM6002Medicare ID - Type Unspecified
MEG12280Medicare UPIN