Provider Demographics
NPI:1609093913
Name:BAIRD, JEFFREY M (PA)
Entity Type:Individual
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First Name:JEFFREY
Middle Name:M
Last Name:BAIRD
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Gender:M
Credentials:PA
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Mailing Address - Street 1:10850 E TRAVERSE HWY
Mailing Address - Street 2:SUITE 4400
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-1364
Mailing Address - Country:US
Mailing Address - Phone:231-346-6800
Mailing Address - Fax:989-340-1214
Practice Address - Street 1:502 W HARRIE ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-1209
Practice Address - Country:US
Practice Address - Phone:906-293-9200
Practice Address - Fax:989-340-1214
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2016-10-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
N48650048Medicare PIN
Q79219Medicare UPIN