Provider Demographics
NPI:1164529467
Name:BAY AREA DIGESTIVE CARE INC
Entity Type:Organization
Organization Name:BAY AREA DIGESTIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAFITY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-663-8061
Mailing Address - Street 1:282 BENEDICT AVE STE D
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2712
Mailing Address - Country:US
Mailing Address - Phone:419-663-8061
Mailing Address - Fax:419-668-2446
Practice Address - Street 1:282 BENEDICT AVE STE D
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2712
Practice Address - Country:US
Practice Address - Phone:419-663-8061
Practice Address - Fax:419-668-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004234207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0657276Medicaid
OHDB1650OtherMEDICARE RAILROAD
OH000000327362OtherANTHEM
OH47366219012OtherMEDICAL MUTUAL OF OHIO
OH9343221Medicare PIN