Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 56261 | CT |
NPI | 1124346481 |
---|---|
Provider Name | Dr. Andrew Raymond Baxter |
First Address | Shelton, CT 06484-6228 |
Second Address | Fairfield, CT 06824-5340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124346481 | (05) | CT |