Provider Demographics
NPI:1922072891
Name:HAYEK, MAROUN E (MD)
Entity Type:Individual
Prefix:
First Name:MAROUN
Middle Name:E
Last Name:HAYEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-3248
Mailing Address - Country:US
Mailing Address - Phone:662-334-6394
Mailing Address - Fax:662-332-1647
Practice Address - Street 1:1514 E UNION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-3248
Practice Address - Country:US
Practice Address - Phone:662-334-6394
Practice Address - Fax:662-332-1647
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16611207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123081Medicaid
AR129581001Medicaid
MS00123081Medicaid
MS900000011Medicare ID - Type Unspecified