Provider Demographics
NPI:1255394086
Name:S AND M BAIG MD PC
Entity type:Organization
Organization Name:S AND M BAIG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAIMUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-561-2220
Mailing Address - Street 1:2 HARBOR BEND CT
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1478
Mailing Address - Country:US
Mailing Address - Phone:636-561-2220
Mailing Address - Fax:636-625-4723
Practice Address - Street 1:2 HARBOR BEND CT
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1488
Practice Address - Country:US
Practice Address - Phone:636-561-2220
Practice Address - Fax:636-625-4723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36225208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
110141833OtherPALMETTO GBA/RAILROAD MCR
107274OtherHEALTHLINK
S04011OtherSSM HEALTHCARE
MO100766OtherBCBS MO PAPER CLAIMS
MOBA202217311Medicaid
MO18031OtherBCBS MO ELECTRONIC
MOBA202217311Medicaid
MO100766OtherBCBS MO PAPER CLAIMS