Individual
MR. WILLIAM JEREMY BAILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, DPT
Contact information
Practice address
1502 PEMBERTON DR, SUITE C, SALISBURY, MD 21801
(410) 749-5050
(410) 749-5057
Mailing address
1502 PEMBERTON DR, SUITE C, SALISBURY, MD 21801
(410) 749-5050
(410) 749-5057
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20434
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143839ZCMG
MEDICARE GROUP MEMBER PROVIDER NUMBER
MD
01
—
362636
MAMSI NUMBER
MD
01
—
612956020004
BLUE CROSS BLUE SHIELD
MD
01
—
F1060004
BCBS FEDERAL NUMBER
MD
01
—
LV43
BCBS MD NUMBER
MD
Enumeration date
08/11/2006
Last updated
10/28/2024
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