Basic Information
Provider Information
NPI: 1598081432
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAIG
FirstName: SOPHIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 670 MASON RIDGE CENTER DR
Address2: STE 300
City: SAINT LOUIS
State: MO
PostalCode: 631418573
CountryCode: US
TelephoneNumber: 3149965772
FaxNumber: 3149967691
Practice Location
Address1: 3015 N BALLAS RD
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631312329
CountryCode: US
TelephoneNumber: 3149965772
FaxNumber: 3149967691
Other Information
ProviderEnumerationDate: 04/16/2010
LastUpdateDate: 02/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X036132583ILN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X2013027459MOY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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