Basic Information
| Provider Information | |||||||||
| NPI: | 1508954835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAXTER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST STE SW200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564924 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 513 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8569633715 | ||||||||
| FaxNumber: | 8566351052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 06/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD037108E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | MA53210 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 1023745 | 01 | HORIZON NJ HEALTH | OTHER | 3182437 | 01 | CIGNA | OTHER | 84027 | 01 | AMERIGROUP | OTHER | 14278 | 01 | UNIVERSITY HEALTH PLAN | OTHER | 146258 | 01 | PENNSYLVANIA BLUE SHIELD | OTHER | P437737 | 01 | OXFORD HEALTH PLAN | OTHER | 110084235 | 01 | RAIL ROAD MEDICARE | OTHER | 146258 | 01 | MAREIHEALTH PPO | OTHER | 3K6105 | 01 | HEALTHNET | OTHER | 123460 | 01 | AETNA | OTHER | 0083872000 | 01 | AMERIHEALTH, HMO, KEYSTONE, IBC | OTHER | 010003720 00 | 01 | AMERICHOICE | OTHER | 1243147 | 01 | UNITED HEALTH CARE | OTHER | 4608402 | 05 | NJ | MEDICAID |