Provider Demographics
NPI:1215530910
Name:BAIG, FAWAD HASAN (PHARMD)
Entity type:Individual
Prefix:
First Name:FAWAD
Middle Name:HASAN
Last Name:BAIG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 8TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1024
Mailing Address - Country:US
Mailing Address - Phone:515-967-1885
Mailing Address - Fax:
Practice Address - Street 1:3414 8TH ST SW
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1024
Practice Address - Country:US
Practice Address - Phone:515-967-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist