Healthcare Provider Details

I. General information

NPI: 1407341423
Provider Name (Legal Business Name): TRENT ROBERT BAILEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3366 OAKDALE AVE N STE 401
ROBBINSDALE MN
55422-2986
US

IV. Provider business mailing address

2800 CAMPUS DR STE 10
PLYMOUTH MN
55441-2669
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-5200
  • Fax:
Mailing address:
  • Phone: 763-520-2940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2018020041
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2021024762
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number82295
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number80145
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2021024762
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: