Healthcare Provider Details

I. General information

NPI: 1619954989
Provider Name (Legal Business Name): ROOMIKA TANWEER BAIG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BAUGHMANS LN STE 150
FREDERICK MD
21702-4651
US

IV. Provider business mailing address

110 BAUGHMANS LN STE 150
FREDERICK MD
21702-4651
US

V. Phone/Fax

Practice location:
  • Phone: 301-696-8813
  • Fax: 301-696-8832
Mailing address:
  • Phone: 301-696-8813
  • Fax: 301-696-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0061582
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: