Provider Demographics
NPI:1255426060
Name:HAYWOOD, MICHELE T (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:T
Last Name:HAYWOOD
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 1:2215 E WATERLOO RD
Mailing Address - Street 2:STE 313
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-3814
Mailing Address - Country:US
Mailing Address - Phone:330-208-2720
Mailing Address - Fax:330-208-2721
Practice Address - Street 1:2215 E WATERLOO RD
Practice Address - Street 2:STE 313
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-3814
Practice Address - Country:US
Practice Address - Phone:330-208-2720
Practice Address - Fax:330-208-2721
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074760207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2103280Medicaid
020041969OtherMEDICARE RAILROAD
000000206412OtherANTHEM
G93342Medicare UPIN
000000206412OtherANTHEM