Provider Demographics
NPI:1982722245
Name:HAYEK, FREDRICK C (MD)
Entity Type:Individual
Prefix:
First Name:FREDRICK
Middle Name:C
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:PO BOX 35546
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44735-5546
Mailing Address - Country:US
Mailing Address - Phone:330-494-2228
Mailing Address - Fax:330-494-2292
Practice Address - Street 1:4911 MUNSON ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3616
Practice Address - Country:US
Practice Address - Phone:330-494-2228
Practice Address - Fax:330-494-2292
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH48676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0570074Medicaid
OHD31379Medicare UPIN
OH0570074Medicaid