Healthcare Provider Details

I. General information

NPI: 1568112431
Provider Name (Legal Business Name): BAILEY SLONE WHITE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 FRANKLIN SQUARE DR
ROSEDALE MD
21237-3936
US

IV. Provider business mailing address

9101 FRANKLIN SQUARE DR
ROSEDALE MD
21237-3936
US

V. Phone/Fax

Practice location:
  • Phone: 419-545-5103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.017285
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: