Individual
MARSHALL BLAKE HAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK ST., RADIOLOGY, URBANA, IL 61801-2530
(217) 383-3270
(217) 383-4116
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036130848
IL
2085R0202X
Diagnostic Radiology Physician
Primary
4301061520
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104363730
—
MI
01
—
11278282
CAQH
MI
01
—
300128669
RR MDCR INDIVIDUAL PIN NO
MI
01
—
MH061520
BC/BS INDIVIDUAL PIN NO
MI
Enumeration date
07/15/2005
Last updated
02/15/2016
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