Individual
CHARLES R BAISDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2776
(706) 721-7837
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 724-6100
(706) 722-5187
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
020403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310002
—
SC
Enumeration date
08/30/2006
Last updated
07/09/2007
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