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Individual
KENNETH E. BAKER
Active
Individual
KENNETH E. BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100970
FL
363AM0700X
Medical Physician Assistant
010532
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CU700Y
QSS SCS MEDICARE PTAN
FL
01
—
HF826A
QSS SCS GROUP PTAN
FL
Enumeration date
06/30/2006
Last updated
03/11/2021
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