Provider Demographics
NPI:1265570063
Name:DONALDSON-BAILEY, MICHELLE E G (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:E G
Last Name:DONALDSON-BAILEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 ST. CLAUDE AVE.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117
Mailing Address - Country:US
Mailing Address - Phone:504-945-8102
Mailing Address - Fax:504-945-1201
Practice Address - Street 1:3224 SAINT CLAUDE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-6659
Practice Address - Country:US
Practice Address - Phone:504-945-8102
Practice Address - Fax:504-945-1201
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD158R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1999695Medicaid
LA4483390001Medicare NSC
LA5U825Medicare PIN
LAU52460Medicare UPIN