Provider Demographics
NPI:1124123716
Name:AZAM BAIG,M.D.
Entity type:Organization
Organization Name:AZAM BAIG,M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-956-6303
Mailing Address - Street 1:224 MAYO RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2951
Mailing Address - Country:US
Mailing Address - Phone:410-956-6303
Mailing Address - Fax:410-956-6637
Practice Address - Street 1:224 MAYO RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2951
Practice Address - Country:US
Practice Address - Phone:410-956-6303
Practice Address - Fax:410-956-6637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020882261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD181521100Medicaid
MD0453912OtherAETNA
MDC023OtherCAPTIAL CARE/BLUE CHOICE
MD0701078005OtherCIGNA
MH2653AOtherBLUE CROSS/BLUE SHIELD
MD88981OtherMAMSI
MD04531OtherAMERIGROUP
MH2653AOtherBLUE CROSS/BLUE SHIELD