Provider Demographics
NPI:1134276587
Name:BAILEY, BRUCE E (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:E
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:112 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2737
Mailing Address - Country:US
Mailing Address - Phone:860-425-8701
Mailing Address - Fax:860-425-8707
Practice Address - Street 1:88 NORWICH NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2518
Practice Address - Country:US
Practice Address - Phone:860-848-1297
Practice Address - Fax:860-848-9875
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT030224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010030224CT01OtherBLUE CROSS
CTC006876OtherCHAMPUS
CTC006876OtherCHAMPUS
CTA36930Medicare UPIN