Healthcare Provider Details

I. General information

NPI: 1265422828
Provider Name (Legal Business Name): BAYHEALTH MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N DUPONT BLVD
MILFORD DE
19963-1019
US

IV. Provider business mailing address

640 S STATE ST
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-672-2319
  • Fax:
Mailing address:
  • Phone: 302-744-7162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberC10004408
License Number StateDE

VIII. Authorized Official

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