MEDICARE: PHYLLIS ARMSTEAD BAEZ M.D.

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
1	2084P0800X	Psychiatry Physician	009900755	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871659342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLLIS ARMSTEAD BAEZ M.D.

Provider Business Mailing Address
First Line	:	515 TAYSIDE ST
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-8724
Country	:	US
Telephone Number	:	910-850-9927
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 VANCE ST
Second Line	:
City	:	CLINTON
State	:	NC
Zip	:	28328-4001
Country	:	US
Telephone Number	:	910-567-6194
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	05/25/2022

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