Individual
ANDREA BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12266 DE PAUL DR STE 310, BRIDGETON, MO 63044-2562
(314) 344-6900
(314) 645-0158
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1854
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000154561
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208832709
—
MO
Enumeration date
07/17/2006
Last updated
10/20/2020
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