Individual
ROBERT B BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
440 NW DIVISION ST, GRESHAM, OR 97030-5506
(503) 215-9500
(503) 215-9525
Mailing address
PO BOX 13994, PORTLAND, OR 97213-0994
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD14712
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080721
—
OR
01
—
110189791
RR MEDICARE
OR
Enumeration date
06/03/2006
Last updated
06/02/2008
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