Maida Patricia Baugh, MD

Individual provider Active NPI Pediatrics Physician · Bolivar, MO

NPI 1508979402 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1508979402
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
2003028755 (MO)
Practice address
1165 N Butterfield Rd
Bolivar, MO 65613-1056
Phone
(417) 777-2121
Fax
(417) 777-2854
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2003028755MOMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2003028755 MO Yes

Addresses

Primary practice location

1165 N Butterfield Rd
Bolivar, MO 65613-1056

Mailing address

1165 N Butterfield Rd
Bolivar, MO 65613-1056
Phone (417) 777-2121

Other providers in Bolivar, MO

All providers in Bolivar, MO · Pediatrics Physician in Missouri

Sources for this page

Verify at the official NPI Registry.