Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | OS014341 | PA |
Y | 208D00000X | General Practice Physician | OS014341 | PA |
NPI | 1316118953 |
---|---|
Provider Name | Dr. Lisa Anne Baird |
First Address | Erie, PA 16501-1828 |
Second Address | Erie, PA 16501-1828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2008 |
Last Update Date | 17/03/2018 |