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General NPI Number Information
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NPI Number | 1942033691
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Entity Type | Individual
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Provider Name | MARGARET ELLEN BAXLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 171 ASHLEY AVE
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City | CHARLESTON
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State | SC
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Zip | 29425-8908
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Country | US
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Telephone | 843-792-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 102 CHADWICK DR
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City | CHARLESTON
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State | SC
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Zip | 29407-7451
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Country | US
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Telephone | 864-561-5669
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | SC
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