Healthcare Provider Details

I. General information

NPI: 1720545536
Provider Name (Legal Business Name): BAYHEALTH MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S GOVERNORS AVE STE 101A
DOVER DE
19904-3530
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-310-8484
  • Fax: 302-744-7989
Mailing address:
  • Phone: 302-744-7000
  • Fax: 302-744-7181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL TRETINA
Title or Position: SR. VICE PRESIDENT/ CFO
Credential:
Phone: 302-744-7162