Provider Demographics
NPI:1013941129
Name:BAIRD, STUART EMERSON (IDC)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:EMERSON
Last Name:BAIRD
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS PENNSYLVANIA (SSBN 735) (GOLD)
Mailing Address - Street 2:
Mailing Address - City:FPO AE
Mailing Address - State:WA
Mailing Address - Zip Code:96698-2122
Mailing Address - Country:US
Mailing Address - Phone:360-315-4205
Mailing Address - Fax:360-396-4247
Practice Address - Street 1:USS PENNSYLVANIA (SSBN 735) (GOLD)
Practice Address - Street 2:
Practice Address - City:FPO AE
Practice Address - State:WA
Practice Address - Zip Code:96698-2122
Practice Address - Country:US
Practice Address - Phone:360-315-4205
Practice Address - Fax:360-396-4247
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman