Individual
DR. MARK C BAXTER
Active
Individual
DR. MARK C BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DPM0000000357
TN
213ES0131X
Foot Surgery Podiatrist
Primary
DPM0000000357
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093-2019-9
VA MEDICAID
VA
01
—
100010536
PHP
TN
01
—
216412
ANTHEM
VA
05
—
3351572
—
TN
01
—
480007576
UNITED HEALTH CARE RAIL R
TN
01
—
62-1402649
EMPLOYER IDENTIFICATION #
—
01
—
621402649
UNITED HEALTH CARE RIVER
TN
01
—
7510238
AETNA
TN
01
—
89548
BCBS OF TN
TN
Enumeration date
10/21/2005
Last updated
07/12/2013
Update your record
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