Provider Demographics
NPI:1508979402
Name:BAUGH, MAIDA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAIDA
Middle Name:PATRICIA
Last Name:BAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1165 N BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-1056
Mailing Address - Country:US
Mailing Address - Phone:417-777-2121
Mailing Address - Fax:417-777-2854
Practice Address - Street 1:1165 N BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1056
Practice Address - Country:US
Practice Address - Phone:417-777-2121
Practice Address - Fax:417-777-2854
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2003028755208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA17435Medicare UPIN