Provider Demographics
NPI:1124267075
Name:DOUGLAS, CLAUDETTE BAIJNATH (PA)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:BAIJNATH
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:206 HENDERSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-0011
Mailing Address - Country:US
Mailing Address - Phone:912-596-8148
Mailing Address - Fax:
Practice Address - Street 1:300 NEW RIVER PKWY
Practice Address - Street 2:STE 17
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-4450
Practice Address - Country:US
Practice Address - Phone:843-784-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1316363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical