Provider Demographics
NPI:1043656119
Name:HAYES, LAUREN MARIE (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1465 SOUTH GRAND BOULEVARD, ROOM 1204
Mailing Address - Street 2:SSM CARDINAL GLENNON CHILDREN'S MEDICAL CENTER
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104
Mailing Address - Country:US
Mailing Address - Phone:314-577-5600
Mailing Address - Fax:314-577-5616
Practice Address - Street 1:1465 SOUTH GRAND BOULEVARD, ROOM 1204
Practice Address - Street 2:SSM CARDINAL GLENNON CHILDREN'S MEDICAL CENTER
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104
Practice Address - Country:US
Practice Address - Phone:314-577-5600
Practice Address - Fax:314-577-5616
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2016010180208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics