Provider Demographics
NPI:1669456505
Name:BAIRD, JENNIFER MAWHINNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MAWHINNEY
Last Name:BAIRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4139 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9034
Mailing Address - Country:US
Mailing Address - Phone:330-702-1281
Mailing Address - Fax:330-702-1287
Practice Address - Street 1:4139 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9034
Practice Address - Country:US
Practice Address - Phone:330-702-1281
Practice Address - Fax:330-702-1287
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35071303M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2153628Medicaid
OHMA0889041Medicare ID - Type Unspecified
OH2153628Medicaid