Individual
DR. BONNIE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2550
Mailing address
3100 MACCORKLE AVE SE, STE 203, CHARLESTON, WV 25304-1228
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19730
WV
208000000X
Pediatrics Physician
Primary
19730
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009273000
—
WV
01
—
001718041
BLUE CROSS BLUE SHIELD
WV
01
—
1053513
WORKERS COMPENSATION
WV
Enumeration date
01/04/2006
Last updated
05/07/2018
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