Provider Demographics
NPI:1992772933
Name:BAILEY, ANDREW ALLISON JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ALLISON
Last Name:BAILEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 RIVERBEND DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8607
Mailing Address - Country:US
Mailing Address - Phone:434-295-2482
Mailing Address - Fax:434-293-8725
Practice Address - Street 1:195 RIVERBEND DR
Practice Address - Street 2:SUITE 2
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8607
Practice Address - Country:US
Practice Address - Phone:434-295-2482
Practice Address - Fax:434-293-8725
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038885174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007371802Medicaid
VASC0001041Medicare PIN
VAB07959Medicare UPIN