Organization
INNOVATIVE TREATMENT CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS A BAIRD NP (OWNER)
(443) 430-2998
Entity
Organization
Contact information
Practice address
325 HOSPITAL DR STE 106, GLEN BURNIE, MD 21061-5806
(917) 873-5716
Mailing address
325 HOSPITAL DR STE 106, GLEN BURNIE, MD 21061-5806
(917) 873-5716
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699298601
—
MD
Enumeration date
01/02/2023
Last updated
05/19/2023
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