Provider Demographics
NPI:1891728093
Name:BAY MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:BAY MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:Q
Authorized Official - Last Name:KACHAVOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-626-5900
Mailing Address - Street 1:4 ELLIOT WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3547
Mailing Address - Country:US
Mailing Address - Phone:603-626-5900
Mailing Address - Fax:603-625-2180
Practice Address - Street 1:4 ELLIOT WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3547
Practice Address - Country:US
Practice Address - Phone:603-626-5900
Practice Address - Fax:603-625-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BARE0199Medicare ID - Type Unspecified