Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2901015014 | MI |
NPI | 1639296973 |
---|---|
Provider Name | Dr. William D. Baxter JR. |
First Address | Ann Arbor, MI 48104-4786 |
Second Address | Ann Arbor, MI 48104-4786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 26/07/2007 |