| Bay Infectious Disease Llc | |
|
750 Harrison Ave Panama City FL 32401-2524 | |
| (850) 913-9294 | |
| Not Available |
| Full Name | Bay Infectious Disease Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 750 Harrison Ave, Panama City, Florida |
| Authorized Official Name and Position | Ikram Haq (MD) |
| Authorized Official Contact | 8509139294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Infectious Disease Llc 750 Harrison Ave Panama City FL 32401-2524 Ph: (850) 913-9294 | Bay Infectious Disease Llc 750 Harrison Ave Panama City FL 32401-2524 Ph: (850) 913-9294 |
| NPI Number | 1366831810 |
|---|---|
| Provider Enumeration Date | 01/21/2015 |
| Last Update Date | 06/15/2015 |
| Medicare PECOS PAC ID | 7012236292 |
|---|---|
| Medicare Enrollment ID | O20150511001126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366831810 | NPI | - | NPPES |
| 014620600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME0075189 (Florida) | Primary |
| Provider Name | Ikram Haq |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1861427288 PECOS PAC ID: 5395733802 Enrollment ID: I20040504000523 |
| Provider Name | Yeneneh Desta |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447408562 PECOS PAC ID: 3678744026 Enrollment ID: I20110915000691 |
| Provider Name | Aurelia Elise Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255839098 PECOS PAC ID: 7113268376 Enrollment ID: I20190416002384 |
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