Individual
CAROLINE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(785) 640-9498
Mailing address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7348
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2012014199
MO
207P00000X
Emergency Medicine Physician
Primary
56425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083938922
—
MO
Enumeration date
03/22/2010
Last updated
01/18/2016
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