Basic Information
| Provider Information | |||||||||
| NPI: | 1750661419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAIG | ||||||||
| FirstName: | IFTEKHAR | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2025 INDIAN ROCKS RD S | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337741035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275867103 | ||||||||
| FaxNumber: | 7275857205 | ||||||||
| Practice Location | |||||||||
| Address1: | 2010 59TH ST W STE 4200 | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342094687 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417943999 | ||||||||
| FaxNumber: | 9417924048 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2011 | ||||||||
| LastUpdateDate: | 02/21/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | UO2895 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | OS12229 | FL | N | Allopathic & Osteopathic Physicians | General Practice | 207RC0000X | OS12229 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.