Provider Demographics
NPI:1508954835
Name:BAXTER, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:BAXTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 513
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-963-3715
Practice Address - Fax:856-635-1052
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037108E207RI0200X
NJMA53210207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023745OtherHORIZON NJ HEALTH
3182437OtherCIGNA
84027OtherAMERIGROUP
14278OtherUNIVERSITY HEALTH PLAN
146258OtherPENNSYLVANIA BLUE SHIELD
P437737OtherOXFORD HEALTH PLAN
110084235OtherRAIL ROAD MEDICARE
146258OtherMAREIHEALTH PPO
3K6105OtherHEALTHNET
123460OtherAETNA
0083872000OtherAMERIHEALTH, HMO, KEYSTONE, IBC
010003720 00OtherAMERICHOICE
1243147OtherUNITED HEALTH CARE
NJ4608402Medicaid
146258Medicare PIN
3K6105OtherHEALTHNET