Provider Demographics
NPI:1205895802
Name:HAYFORD, KWEKU AMOANU (MD)
Entity type:Individual
Prefix:
First Name:KWEKU
Middle Name:AMOANU
Last Name:HAYFORD
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 1:6000 EXECUTIVE BLVD STE 625
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3877
Mailing Address - Country:US
Mailing Address - Phone:240-314-7080
Mailing Address - Fax:410-367-2235
Practice Address - Street 1:7307 MACARTHUR BLVD STE 207
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1014
Practice Address - Country:US
Practice Address - Phone:301-701-6060
Practice Address - Fax:301-701-6070
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424855207R00000X
MDD0062108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101136703Medicaid
PA101136703Medicaid
PAI18763Medicare UPIN
PA084368KZPMedicare ID - Type Unspecified