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Individual

DR. MICHAEL RANDEL BAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
459 LOCUST AVE, MB #26, CHARLOTTESVILLE, VA 22902-4808
(434) 982-7150
Mailing address
PO BOX 11647, DAYTONA BEACH, FL 32120-1647
(386) 274-7800
(386) 274-7801

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101223301
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010046220
VA
05
010134081
VA
01
165761
ANTHEM SVC/HEALTHKEEPERS
VA
01
224878
SOUTHERN HEALTH
VA
01
40565
COMMUNITY HEALTH
VA
05
40565
VA
01
930113913
MEDICARE PIN
VA
01
P00192026
MEDICARE PIN
VA
Enumeration date
01/24/2006
Last updated
08/06/2008
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