Healthcare Provider Details

I. General information

NPI: 1952128258
Provider Name (Legal Business Name): BAYHEALTH MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 BAY RD UNIT B
DOVER DE
19901
US

IV. Provider business mailing address

665 BAY RD UNIT B
DOVER DE
19901
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6592
  • Fax:
Mailing address:
  • Phone: 302-744-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

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