MEDICARE: COURTNEY DREW BAILEY

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	207VX0201X	Gynecologic Oncology Physician	83467	SC

General Provider Information

NPI Number	:	1992116834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY DREW BAILEY

Provider Business Mailing Address
First Line	:	1470 TOBIAS GADSON BLVD STE 110
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4835
Country	:	US
Telephone Number	:	843-556-4380
Fax Number	:	843-571-5531

Provider Business Practice Location Address
First Line	:	1470 TOBIAS GADSON BLVD STE 110
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4835
Country	:	US
Telephone Number	:	843-556-4380
Fax Number	:	843-571-5531

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

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	06/17/2022

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Directions to “ COURTNEY DREW BAILEY ” Practice Location

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