Individual provider · NPI-1

Cody M Baxter

Physician Assistant · Fargo, ND

NPI number1922590181
StatusActive
Last updated in NPPESAug 8, 2023

Details

NPI
1922590181
Entity type
Individual (NPI-1)
Name
Cody M Baxter
Sex
Male
Sole proprietor
No
Enumeration date
Jun 4, 2018
Certification date
Aug 8, 2023
Last updated
Aug 8, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant––Yes

Practice location

3625 Lincoln St S Ste C
Fargo, ND 58104-7766

Phone 701-532-2458 · Fax 701-935-7277

Mailing address

3625 Lincoln St S Ste C
Fargo, ND 58104-7766

Phone 701-532-2458 · Fax 701-935-7277

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