Individual
MELISSA JEAN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
255 ENTERPRISE BLVD STE 101, GREENVILLE, SC 29615-3530
(864) 454-8120
(864) 454-8125
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OT012771
PA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
36736
SC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
OT012771
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367366
—
SC
Enumeration date
10/16/2008
Last updated
06/07/2021
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