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General NPI Number Information
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NPI Number | 1083682876
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Entity Type | Individual
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Provider Name | CHERYL L BAILEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 720 S VANBUREN ST SUITE 101
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City | GREEN BAY
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State | WI
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Zip | 54301-3504
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Country | US
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Telephone | 920-433-3420
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Fax | 920-338-6859
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Provider Business Mailing Address
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Address Line | 910 E 26TH ST STE 200
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-4526
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Country | US
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Telephone | 612-884-6300
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Fax | 612-884-6363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 38956
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 38956
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 71627-20
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License Number State | WI
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