Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 089299 | OH |
NPI | 1003943879 |
---|---|
Provider Name | Dr. Mirza Moazzam-Ali Baig |
First Address | Toledo, OH 43615-1702 |
Second Address | Toledo, OH 43615-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2725975 | (05) | OH |
I74239 | (02) | OH |