Bailly, Richard C

Bailly, Richard C is an individual health care provider with primary practice located at 700 1St Ave S , Fargo ND 58103-1802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Bailly, Richard C can be contacted via phone (701) 234-4000.

Contact Information

Primary practice address
700 1St Ave S Fargo ND 58103-1802
Fax: (701) 234-4160
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 3760 North Dakota
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 19797 Minnesota

Profile Details

NPI number 1215954201
LBN Legal business name Bailly, Richard C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Dec 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215954201 NPPES
North Dakota MEDICAID 12714

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