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General NPI Number Information
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NPI Number | 1124346481
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Entity Type | Individual
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Provider Name | DR. ANDREW RAYMOND BAXTER
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Gender | Male
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 75 KINGS HIGHWAY CUTOFF
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City | FAIRFIELD
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State | CT
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Zip | 06824-5340
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Country | US
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Telephone | 203-266-1735
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Fax |
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Provider Business Mailing Address
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Address Line | 6 RESEARCH DR STE 105
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City | SHELTON
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State | CT
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Zip | 06484-6228
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Country | US
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Telephone | 203-210-6340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 56261
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 56261
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License Number State | CT
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