Provider Demographics
NPI:1881989630
Name:BAIRD, JOSHUA PHILIP (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PHILIP
Last Name:BAIRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:14 MEDICAL PARK
Practice Address - Street 2:STE 350 EMERGENCY MEDICINE DEPT
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7184
Practice Address - Fax:803-434-3946
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL33529207P00000X
SC33529207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC13089068OtherMEDICARE PIN
SC335293Medicaid
SCSC13088510OtherMEDICARE PIN