MEDICARE: MAIMUNA BAIG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	36225	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100766	OTHER	MO	BCBS MO PAPER CLAIMS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	S04011	OTHER		SSM HEALTHCARE
4	110141833	OTHER		PALMETTO GBA/RAILROAD MCR
5	18031	OTHER	MO	BCBS MO ELECTRONIC
6	107274	OTHER		HEALTHLINK

General Provider Information

NPI Number	:	1679536403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIMUNA BAIG MD

Provider Business Mailing Address
First Line	:	2 HARBOR BEND CT
Second Line	:	SUITE 202
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-1478
Country	:	US
Telephone Number	:	636-561-2220
Fax Number	:	636-625-4723

Provider Business Practice Location Address
First Line	:	2 HARBOR BEND CT
Second Line	:
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-1478
Country	:	US
Telephone Number	:	636-561-2220
Fax Number	:	636-625-4723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	03/26/2014

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Directions to “ MAIMUNA BAIG MD” Practice Location

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