Basic Information
| Provider Information | |||||||||
| NPI: | 1619108834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAIG | ||||||||
| FirstName: | SAQIB | ||||||||
| MiddleName: | HASAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 834 WALNUT ST STE 650 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159555161 | ||||||||
| FaxNumber: | 2159236003 | ||||||||
| Practice Location | |||||||||
| Address1: | 834 WALNUT ST STE 650 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159555161 | ||||||||
| FaxNumber: | 2159236003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2009 | ||||||||
| LastUpdateDate: | 11/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 60389 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | P24252 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | MD465342 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 1619108834 | 05 | WI | MEDICAID |