Provider Demographics
NPI:1013086834
Name:BAILEY, MARSHA LEE (MD MPH FACOEM)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:LEE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD MPH FACOEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 1203
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526
Mailing Address - Country:US
Mailing Address - Phone:304-757-0270
Mailing Address - Fax:304-757-0268
Practice Address - Street 1:1203 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 1203
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526
Practice Address - Country:US
Practice Address - Phone:304-757-0270
Practice Address - Fax:304-757-0268
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA4143481Medicare ID - Type Unspecified
A12709Medicare UPIN