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Contact Information

DOMINIC T HAYNESWORTH SR, MD
2351 E 22ND ST
CLEVELAND, OH44115-3111
 Phone: 216-861-6200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Personal Emergency Response Attendant

146D00000X
Indicates primary specialty

NPI Profile & details for DOMINIC T HAYNESWORTH SR · (Male)

NPI # 1073550752
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2006
Last updated 08/10/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 35046582
  • OH License # 46583
  • OH Medicaid 0464939
  • OH Other 942460636429 CARESOURCE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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