Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 56518 | GA |
NPI | 1073548418 |
---|---|
Provider Name | Dr. Amy L Baxter |
First Address | Atlanta, GA 30307-2327 |
Second Address | Atlanta, GA 30342-1605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H34672 | (02) |