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General NPI Number Information
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NPI Number | 1568841013
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Entity Type | Individual
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Provider Name | BAILEY STEPHANIE SU M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1220 MAGNOLIA ST # 4C
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City | GREENSBORO
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State | NC
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Zip | 27401-1309
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Country | US
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Telephone | 336-832-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 5841 S MARYLAND AVE MC6040
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 125066626
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 2025-01612
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RTL22-0555
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2025-01612
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License Number State | NC
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