Doctor Name: | MR. BARRY O BAKER |
NPI Number: | 1497716690 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | C0002344 |
Business Practice Address: | 101 Colonial Way Suite A Rising Sun, MD - 219112283 |
Business Phone Number: | 4106586696 |
Business Fax Number: | 4106584548 |
Mailing Address: | 101 Colonial Way, Suite A RISING SUN |
State: | MD |
Postal Code: | 219112283 |
Phone Number: | 4106586696 |
Fax Number: | 4106584548 |
NPI Enumeration Date: | 03/29/2006 |
NPI Last Update Date: | 11/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | C0002344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |