Healthcare Provider Details

I. General information

NPI: 1306289020
Provider Name (Legal Business Name): ANNIE MARTHA BAILEY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 HALF STREET SE
WASHINGTON DC
20003
US

IV. Provider business mailing address

915 HALF ST SE
WASHINGTON DC
20003-3658
US

V. Phone/Fax

Practice location:
  • Phone: 202-601-0397
  • Fax:
Mailing address:
  • Phone: 202-546-4504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD048681
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: