Healthcare Provider Details

I. General information

NPI: 1740049626
Provider Name (Legal Business Name): BAYHEALTH MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 BAY RD UNIT B
DOVER DE
19901
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-9310
  • Fax: 302-744-9312
Mailing address:
  • Phone: 302-744-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TRETINA
Title or Position: CFO
Credential:
Phone: 302-744-7162