Healthcare Provider Details

I. General information

NPI: 1689656258
Provider Name (Legal Business Name): STEVEN J BAILIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 UNIVERSITY AVE
WEST DES MOINES IA
50266-8209
US

IV. Provider business mailing address

5880 UNIVERSITY AVE
WEST DES MOINES IA
50266-8209
US

V. Phone/Fax

Practice location:
  • Phone: 515-633-3600
  • Fax: 515-288-0840
Mailing address:
  • Phone: 515-633-3600
  • Fax: 515-288-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number28166
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number28166
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: