Provider Demographics
NPI:1356659783
Name:BAILEY, ADIJA D (PA-C)
Entity Type:Individual
Prefix:
First Name:ADIJA
Middle Name:D
Last Name:BAILEY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1600 PERIMETER PARK DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6011 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 104A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6248
Practice Address - Country:US
Practice Address - Phone:919-405-2100
Practice Address - Fax:919-806-2004
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2013-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-02540363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-02540OtherLICENSE NUMBER
NCNC3709AMedicare PIN