Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101254060 | VA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 068103 | GA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 60267385 | NY |
N | 2081P2900X | Pain Medicine | 0101254060 | VA |
Y | 2081P2900X | Pain Medicine | 25285 | WV |
N | 2081P2900X | Pain Medicine | D0087846 | MD |
N | 225100000X | Physical Therapist | ||
N | 225100000X | Physical Therapist | 029209 | NY |
NPI | 1033393871 |
---|---|
Provider Name | Mr. Waheed S Baksh |
First Address | Martinsburg, WV 25401-2864 |
Second Address | Winchester, VA 22601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101254060 | MEDICAL LICENSE (01) | VA |
25285 | WEST VIRGINIA BOARD OF MEDICINE (01) | WV |
D0087846 | MARYLAND BOARD OF PHYSICIANS (01) | MD |