1104860279 NPI number — DR. MACARAN ALEXANDER BAIRD M.D.

Table of content: LUCILLE MURPHY (NPI 1073070504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104860279 NPI number — DR. MACARAN ALEXANDER BAIRD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAIRD
Provider First Name:
MACARAN
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104860279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
720 WASHINGTON AVE SE
Provider Second Line Business Mailing Address:
UNIVERSITY OF MINNESOTA PHYSICIANS
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-884-0649
Provider Business Mailing Address Fax Number:
612-676-8992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 E 28TH ST.
Provider Second Line Business Practice Location Address:
UMPHYSICIANS SMILEY'S CLINIC
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-333-0770
Provider Business Practice Location Address Fax Number:
612-333-1986
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  22663 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 359J3BA . This is a "BCBS PCC" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 75G27BA . This is a "BCBS PHALEN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0556571 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01-09759 . This is a "MEDICA PCC" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01-11236 . This is a "MEDICA SMILEY'S" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 068G6BA . This is a "BCBS BETHESDA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 892724300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 116745 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 75G26BA . This is a "BCBS BFM" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 008L3BA . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01-17522 . This is a "MEDICA BETHESDA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01-17523 . This is a "MEDICA BFM" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01-17525 . This is a "MEDICA PHALEN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 767470 . This is a "ARAZ" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1014339 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP17840 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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