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General NPI Number Information
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NPI Number | 1669404059
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Entity Type | Individual
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Provider Name | CHARLES F BAY PA
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 4503 MAIN ST
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City | SHALLOTTE
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State | NC
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Zip | 28470-4447
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Country | US
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Telephone | 910-755-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 200 BARR HARBOR DR FOUR TOWER BRIDGE, SUITE 200
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City | WEST CONSHOHOCKEN
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State | PA
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Zip | 19428-6637
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Country | US
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Telephone | 848-240-2812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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