Provider Demographics
NPI:1427214063
Name:BAIG, MIRZA SHAHRUKH (MD)
Entity type:Individual
Prefix:DR
First Name:MIRZA
Middle Name:SHAHRUKH
Last Name:BAIG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:671 HIOAKS RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4072
Mailing Address - Country:US
Mailing Address - Phone:804-272-5814
Mailing Address - Fax:804-560-0232
Practice Address - Street 1:8485 BELL CREEK RD UNIT B2
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3866
Practice Address - Country:US
Practice Address - Phone:804-559-9757
Practice Address - Fax:804-559-9341
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-03-25
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Provider Licenses
StateLicense IDTaxonomies
VA0101263932207RN0300X
VA0116029295390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1427214063Medicaid
TX390079701Medicaid
MD211878Medicare Oscar/Certification