Individual
SHELLEY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3729 TEAYS VALLEY RD, STE 100, HURRICANE, WV 25526-9705
(304) 760-6040
(304) 760-6042
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21164
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1810211000
—
WV
05
—
2511893
—
OH
01
—
P00304367
MEDICARE-RR PROVIDER NUMBER
WV
Enumeration date
03/24/2006
Last updated
11/12/2020
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