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General NPI Number Information
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NPI Number | 1750332284
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Entity Type | Individual
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Provider Name | MIRZA BAIG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 3520 BEAVER AVE SUITE G
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City | DES MOINES
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State | IA
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Zip | 50310-3264
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Country | US
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Telephone | 515-277-3455
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22112
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City | CLIVE
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State | IA
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Zip | 50325-9402
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Country | US
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Telephone | 515-210-2806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 34037
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License Number State | IA
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