Individual
ILA EVANS BAUGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2359 HIGHWAY 105, BOONE, NC 28607-7814
(828) 265-5391
(828) 265-5394
Mailing address
2359 HIGHWAY 105, BOONE, NC 28607
(828) 265-5391
(828) 265-5394
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25771
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13903
BLUE CROSS BLUE SHIELD
NC
Enumeration date
03/20/2007
Last updated
12/22/2008
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