Provider Demographics
NPI:1699746776
Name:BAY, RANDALL (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:BAY
Suffix:
Gender:M
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:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:UNION PIER
Mailing Address - State:MI
Mailing Address - Zip Code:49129-0390
Mailing Address - Country:US
Mailing Address - Phone:563-449-6868
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 390
Practice Address - Street 2:
Practice Address - City:UNION PIER
Practice Address - State:MI
Practice Address - Zip Code:49129-0390
Practice Address - Country:US
Practice Address - Phone:563-449-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075589207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine