Provider Demographics
NPI:1831137660
Name:BAILEY, BONNIE MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:MARGARET
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 ANNE ST NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5114
Mailing Address - Country:US
Mailing Address - Phone:218-333-2020
Mailing Address - Fax:
Practice Address - Street 1:1611 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5114
Practice Address - Country:US
Practice Address - Phone:218-333-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN44298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4443829-00Medicaid
MN01-09476OtherMN MEDICA
MN1031162OtherMN PREFERRED ONE
080184887OtherRAILROAD MEDICARE
MN212T6BAOtherMN BLUECROSS BLUESHIELD
MNHP39360OtherMN HEALTHPARTNERS
MN080022117Medicare UPIN
MN01-09476OtherMN MEDICA
F65819Medicare UPIN