Individual
DR. GARY W BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
2525 BURTON ST SE, GRAND RAPIDS, MI 49546
(616) 957-2410
(616) 957-2411
Mailing address
2525 BURTON ST SE, GRAND RAPIDS, MI 49546-4834
(616) 957-2410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101007477
MI
207Q00000X
Family Medicine Physician
Primary
GB007477
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154103875
BCBSM ID
MI
05
—
1779765
—
MI
Enumeration date
01/27/2006
Last updated
05/17/2018
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