Provider Demographics
NPI:1447947809
Name:STEELE, BAILLIE R
Entity type:Individual
Prefix:
First Name:BAILLIE
Middle Name:R
Last Name:STEELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 RICHARDSON ST APT 4214
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-4438
Mailing Address - Country:US
Mailing Address - Phone:803-431-9234
Mailing Address - Fax:
Practice Address - Street 1:3600 FOREST DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4057
Practice Address - Country:US
Practice Address - Phone:803-779-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant