Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 20096 | MT |
NPI | 1023084605 |
---|---|
Provider Name | Steven Bailey |
First Address | Great Falls, MT 59405-5161 |
Second Address | Great Falls, MT 59405-5161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E86002 | (02) | KS |