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General NPI Number Information
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NPI Number | 1467858498
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Entity Type | Organization
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Legal Business Name | THE BAILEY MEDICAL GROUP PC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 15639 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3541
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Country | US
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Telephone | 313-910-0613
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Fax | 313-486-0141
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Provider Business Mailing Address
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Address Line | 4777 E OUTER DR 110
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City | DETROIT
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State | MI
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Zip | 48234-3241
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Country | US
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Telephone | 313-910-0613
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Fax | 313-486-0141
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG A. BAILEY
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Credential | MD
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Telephone | 313-910-0613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number | 4301093034
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301093034
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License Number State | MI
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