Provider Demographics
NPI:1346424009
Name:BAY CITY VASCULAR, PC
Entity Type:Organization
Organization Name:BAY CITY VASCULAR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-893-8361
Mailing Address - Street 1:2010 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7606
Mailing Address - Country:US
Mailing Address - Phone:989-893-8361
Mailing Address - Fax:989-893-3528
Practice Address - Street 1:2010 15TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7606
Practice Address - Country:US
Practice Address - Phone:989-893-8361
Practice Address - Fax:989-893-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIVG0655562086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty