Provider Demographics
NPI:1669616520
Name:BAIRD-CROSS, NNEMDI AMANDA (DO)
Entity type:Individual
Prefix:
First Name:NNEMDI
Middle Name:AMANDA
Last Name:BAIRD-CROSS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LUBRANO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7564
Mailing Address - Country:US
Mailing Address - Phone:410-266-5852
Mailing Address - Fax:410-266-5095
Practice Address - Street 1:129 LUBRANO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7564
Practice Address - Country:US
Practice Address - Phone:410-266-5852
Practice Address - Fax:410-266-5095
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH76472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03476208Medicaid
NYJ400076538Medicare PIN