Basic Information
Provider Information
NPI: 1881814325
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAY
FirstName: MIHEE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2931 E BIDDLE ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212133939
CountryCode: US
TelephoneNumber: 4439231886
FaxNumber: 4439231875
Practice Location
Address1: 707 N BROADWAY
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212051832
CountryCode: US
TelephoneNumber: 4439239200
FaxNumber: 4439231895
Other Information
ProviderEnumerationDate: 04/26/2007
LastUpdateDate: 12/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2080P0008XD71447MDY Allopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities

No ID Information.


Home