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NPI Code Detail

MEDICARE: AMY REBECCA BAEZ

MEDICARE: AMY REBECCA BAEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363A00000XPhysician Assistant0010-09229NC
3363A00000XPhysician Assistant017846-1NY

General Provider Information

NPI Number : 1245625011
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY REBECCA BAEZ
Provider Business Mailing Address
First Line : PO BOX 604136
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-4136
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2150 SHIPYARD BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-8052
Country : US
Telephone Number : 910-662-9300
Fax Number : 910-662-9400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2015
Last Update Date : 03/19/2026

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Directions to “ AMY REBECCA BAEZ ” Practice Location

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