=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669456505
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER MAWHINNEY BAIRD MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2005
-----------------------------------------------------
Last Update Date | 06/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4139 BOARDMAN CANFIELD RD STE 1
-----------------------------------------------------
City | CANFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44406-9034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-702-1281
-----------------------------------------------------
Fax | 330-702-1287
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 DEBARTOLO PL STE 200
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44512-6095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-729-8145
-----------------------------------------------------
Fax | 330-965-5229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 35.071303
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------