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1083938922

NPI Code Detail

MEDICARE: CAROLINE BAILEY MD

MEDICARE: CAROLINE BAILEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	2012014199	MO
2	207P00000X	Emergency Medicine Physician	87620-20	WI
3	207P00000X	Emergency Medicine Physician	56425	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083938922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE BAILEY MD

Provider Business Mailing Address
First Line	:	1575 BEAM AVE
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-1126
Country	:	US
Telephone Number	:	651-232-7348
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 BEAM AVE
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-1126
Country	:	US
Telephone Number	:	785-640-9498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	06/09/2026

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Directions to “ CAROLINE BAILEY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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