Provider Demographics
NPI:1952463887
Name:BAY, SCOT N (MD)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:N
Last Name:BAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 SUN VALLEY DR
Mailing Address - Street 2:SUITE B1
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5612
Mailing Address - Country:US
Mailing Address - Phone:678-822-0250
Mailing Address - Fax:678-822-0251
Practice Address - Street 1:555 SUN VALLEY DR
Practice Address - Street 2:SUITE B1
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5612
Practice Address - Country:US
Practice Address - Phone:678-822-0250
Practice Address - Fax:678-822-0251
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA400022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E86353Medicare UPIN
GA00660602BMedicaid
GA26BDGNXMedicare ID - Type Unspecified