Provider Demographics
NPI:1881765741
Name:BAIG, MIRZA AMIN (MD FRCS PA)
Entity type:Individual
Prefix:
First Name:MIRZA
Middle Name:AMIN
Last Name:BAIG
Suffix:
Gender:M
Credentials:MD FRCS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 RACE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BALTIMORE COUNTY
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-574-3424
Mailing Address - Fax:410-574-3498
Practice Address - Street 1:1232 RACE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BALTIMORE COUNTY
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:410-574-3424
Practice Address - Fax:410-574-3498
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0018839207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1258Medicare ID - Type Unspecified
E12759Medicare UPIN