Healthcare Provider Details

I. General information

NPI: 1750320578
Provider Name (Legal Business Name): PATRICIA MARIE BAILEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 GERMANTOWN AVE
PHILADELPHIA PA
19118-2718
US

IV. Provider business mailing address

8815 GERMANTOWN AVE SUITE 40
PHILADELPHIA PA
19118-2722
US

V. Phone/Fax

Practice location:
  • Phone: 215-248-8252
  • Fax: 215-248-8272
Mailing address:
  • Phone: 215-248-3100
  • Fax: 215-248-3971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD027176E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: