Provider Demographics
NPI:1093740326
Name:BAIG, MIRZA H (MD)
Entity Type:Individual
Prefix:
First Name:MIRZA
Middle Name:H
Last Name:BAIG
Suffix:
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 1:13900 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5046
Mailing Address - Country:US
Mailing Address - Phone:301-725-5652
Mailing Address - Fax:301-483-3723
Practice Address - Street 1:13900 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5046
Practice Address - Country:US
Practice Address - Phone:301-725-5652
Practice Address - Fax:301-483-3723
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0013689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62322Medicare UPIN
MD000P30133Medicare ID - Type Unspecified