Individual
GROVER BAXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
433 W MAIN ST, HYANNIS, MA 02601-3644
(508) 778-4777
(508) 771-9555
Mailing address
433 W MAIN ST, HYANNIS, MA 02601-3644
(508) 778-4777
(508) 771-9555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40570
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2070162
—
MA
01
—
6566
HARVARD PILGRIM
—
01
—
703644
TUFTS
—
Enumeration date
04/17/2006
Last updated
10/13/2015
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