Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35754 | AZ |
N | 111NI0900X | Internist | 35754 | AZ |
Y | 207R00000X | Internist | MD00049361 | WA |
Y | 111NI0900X | Internist | MD00049361 | WA |
N | 208D00000X | General Practice Physician | MD00049361 | WA |
NPI | 1023037009 |
---|---|
Provider Name | Mohammad Qasim Baig |
First Address | Tacoma, WA 98405-4234 |
Second Address | Tacoma, WA 98405-4234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BB9768702 | DEA (01) |