Individual
REBECCA MILLER BAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3050 MONTVALE DR STE A, SPRINGFIELD, IL 62704-6924
(217) 726-8096
Mailing address
722 NEWMAN RD, NEW BERN, NC 28562-5238
(252) 633-5057
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036133207
IL
2085R0202X
Diagnostic Radiology Physician
2019-02567
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036133207
—
IL
Enumeration date
06/11/2008
Last updated
10/28/2020
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