Provider Demographics
NPI:1689120453
Name:HAYE, ORVILLE
Entity type:Individual
Prefix:
First Name:ORVILLE
Middle Name:
Last Name:HAYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HICKORY RD
Mailing Address - Street 2:#681
Mailing Address - City:WASHINGTON GROVE
Mailing Address - State:MD
Mailing Address - Zip Code:20880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 HICKORY RD
Practice Address - Street 2:#681
Practice Address - City:WASHINGTON GROVE
Practice Address - State:MD
Practice Address - Zip Code:20880
Practice Address - Country:US
Practice Address - Phone:301-355-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1021611744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management