Provider Demographics
NPI:1619156957
Name:BAILEY, ASHA LENORA (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHA
Middle Name:LENORA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:121 PARK CENTRAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6476
Mailing Address - Country:US
Mailing Address - Phone:803-252-9907
Mailing Address - Fax:803-252-9906
Practice Address - Street 1:121 PARK CENTRAL DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-252-9907
Practice Address - Fax:803-252-9906
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2024-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC1541207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC015414Medicaid