Provider Demographics
NPI:1730113358
Name:BAYLY, ERICA E (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:E
Last Name:BAYLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 POND PARK RD.
Mailing Address - Street 2:STE. 102
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4309
Mailing Address - Country:US
Mailing Address - Phone:781-337-5555
Mailing Address - Fax:781-331-0300
Practice Address - Street 1:2 POND PARK RD.
Practice Address - Street 2:STE. 102
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4309
Practice Address - Country:US
Practice Address - Phone:781-337-5555
Practice Address - Fax:781-331-0300
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238635207XX0801X, 390200000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110082239AMedicaid