Healthcare Provider Details

I. General information

NPI: 1952996563
Provider Name (Legal Business Name): BAYHEALTH MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1074 S STATE ST
DOVER DE
19901-6925
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-3970
  • Fax:
Mailing address:
  • Phone: 302-744-6941
  • Fax: 302-744-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TRETINA
Title or Position: SENIOR VP/ CFO
Credential: CPA, FHFMA, FACHE
Phone: 302-744-7162