Provider Demographics
NPI:1023117033
Name:BAILEY, WENDY (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
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 1:3340 PROVIDENCE DR
Mailing Address - Street 2:SUITE A-351
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4691
Mailing Address - Country:US
Mailing Address - Phone:907-212-4824
Mailing Address - Fax:907-212-4831
Practice Address - Street 1:3340 PROVIDENCE DR
Practice Address - Street 2:SUITE A-351
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4691
Practice Address - Country:US
Practice Address - Phone:907-212-4824
Practice Address - Fax:907-212-4831
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK58122080P0205X
MT190122080P0205X
CAG566722080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK6946Medicaid