Individual
CORTIS WARD BAILEY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 332-1072
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 332-1072
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000104167
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0936PA
MEDICAID OF SC
SC
01
—
P00222783
RAILROAD MEDICARE
NC
Enumeration date
04/04/2006
Last updated
09/23/2010
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