Provider Demographics
NPI:1225231665
Name:BAQAUDDIN, ANIQA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIQA
Middle Name:
Last Name:BAQAUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANIQA
Other - Middle Name:
Other - Last Name:BAQA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1329 AMANDA JO DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1329 AMANDA JO DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2625
Practice Address - Country:US
Practice Address - Phone:270-766-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine