| Doctor Name: | MISTY T JUSTUS-BAKER |
| NPI Number: | 1023101680 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 103461 |
| Business Practice Address: | 14508 James B White Hwy S Tabor City, NC - 284638358 |
| Business Phone Number: | 9106537000 |
| Business Fax Number: | 9107214101 |
| Mailing Address: | Po Box 602530, CHARLOTTE |
| State: | NC |
| Postal Code: | 282602530 |
| Phone Number: | 9106537000 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 02/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 103461 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |