Provider Demographics
NPI:1205824513
Name:BAIG, NUSRATH HASAN (MD)
Entity Type:Individual
Prefix:
First Name:NUSRATH
Middle Name:HASAN
Last Name:BAIG
Suffix:
Gender:F
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:PO BOX 690913
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0913
Mailing Address - Country:US
Mailing Address - Phone:407-808-5421
Mailing Address - Fax:
Practice Address - Street 1:6601 CENTRAL FLORIDA PARKWAY
Practice Address - Street 2:CENTRAL FLORIDA BEHAVIORAL HOSPITAL
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821
Practice Address - Country:US
Practice Address - Phone:407-808-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV168212084P0800X
FLME1063082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0115192000Medicaid
WV001711183OtherBCBS
WVF30529Medicare UPIN
WV0719032Medicare ID - Type Unspecified