Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2011032939 | MO |
Y | 2080P0204X | Pediatric Emergency Doctor | 2011032939 | MO |
NPI | 1093091357 |
---|---|
Provider Name | Dr. Hemina Bailey |
First Address | St. Louis, MO 63110-2515 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2011 |
Last Update Date | 01/09/2015 |