Provider Demographics
NPI:1689861791
Name:LEIGH ANNE BAINS MD
Entity type:Organization
Organization Name:LEIGH ANNE BAINS MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-539-6248
Mailing Address - Street 1:PO BOX 2460
Mailing Address - Street 2:
Mailing Address - City:TEATICKET
Mailing Address - State:MA
Mailing Address - Zip Code:02536-2460
Mailing Address - Country:US
Mailing Address - Phone:508-548-3699
Mailing Address - Fax:
Practice Address - Street 1:5 INDUSTRIAL DR STE 105
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3465
Practice Address - Country:US
Practice Address - Phone:508-539-6248
Practice Address - Fax:508-539-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2077132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ5115OtherBLUE SHIELD
MAH64745Medicare UPIN
MAA34233Medicare Oscar/Certification