MEDICARE: WENDY BAILEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0205X	Pediatric Endocrinology Physician	5812	AK
2	2080P0205X	Pediatric Endocrinology Physician	19012	MT
3	2080P0205X	Pediatric Endocrinology Physician	G56672	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023117033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY BAILEY MD

Provider Business Mailing Address
First Line	:	3340 PROVIDENCE DR
Second Line	:	SUITE A-351
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4691
Country	:	US
Telephone Number	:	907-212-4824
Fax Number	:	907-212-4831

Provider Business Practice Location Address
First Line	:	3340 PROVIDENCE DR
Second Line	:	SUITE A-351
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4691
Country	:	US
Telephone Number	:	907-212-4824
Fax Number	:	907-212-4831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/24/2012

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Directions to “ WENDY BAILEY MD” Practice Location

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