Provider Demographics
NPI:1730286923
Name:BASKETT, DEBRA RENEE (MD)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:RENEE
Last Name:BASKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 BROOMSEDGE COURT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610
Mailing Address - Country:US
Mailing Address - Phone:919-231-7415
Mailing Address - Fax:
Practice Address - Street 1:1001 ROCK QUARRY ROAD
Practice Address - Street 2:ROCK QUARRY ROAD FAMILY MEDICINE
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-833-3111
Practice Address - Fax:919-833-3327
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
16205OtherWELLPATH
13641OtherBLUE CROSS BLUE SHIELD
NC8913641Medicaid
1825273OtherUNITED HEALTH CARE
200015OtherCIGNA
80109621OtherRAILROAD MEDICARE
NC8913641Medicaid
16205OtherWELLPATH