Provider Demographics
NPI:1265439095
Name:BAIRD, DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 MAIN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-371-7010
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:190 GROTON RD STE 120
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1124
Practice Address - Country:US
Practice Address - Phone:978-772-2424
Practice Address - Fax:978-369-6260
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1286363AM0700X
MAPA1286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010286OtherCONNECTICARE
970025541OtherRAILROAD MEDICARE
970025541OtherRAILROAD MEDICARE
AP1695Medicare PIN