Individual
DR. ELAINE B BAXLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
643 HIGHWAY 1 S, LUGOFF, SC 29078-9174
(803) 243-0988
Mailing address
1606 LAKEVIEW AVE, CAMDEN, SC 29020-2929
(803) 243-0988
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
12579
SC
207Q00000X
Family Medicine Physician
12579
SC
2083X0100X
Occupational Medicine Physician
Primary
12579
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125796
—
SC
Enumeration date
03/28/2006
Last updated
07/12/2024
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