Healthcare Provider Details

I. General information

NPI: 1043321532
Provider Name (Legal Business Name): BAY HEMATOLOGY ONCOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8221 TEAL DR SUITE 301
EASTON MD
21601-7227
US

IV. Provider business mailing address

8221 TEAL DR SUITE 301
EASTON MD
21601-7227
US

V. Phone/Fax

Practice location:
  • Phone: 410-820-5945
  • Fax: 410-820-9642
Mailing address:
  • Phone: 410-820-5945
  • Fax: 410-820-9642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD39887
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2132443
License Number StateMD

VIII. Authorized Official

Name: DR. DAVID HALE SMITH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-820-5945