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Organization
DERMATOLOGY REALM AND FAMILY PRACTICE
Active
Organization
DERMATOLOGY REALM AND FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM W. BAKER MD (MEMBER)
(901) 362-7170
Entity
Organization
Contact information
Practice address
2120 MERCHANTS ROW STE 2, GERMANTOWN, TN 38138-0806
(901) 362-7170
(901) 365-9712
Mailing address
2120 MERCHANTS ROW STE 2, GERMANTOWN, TN 38138-0806
(901) 362-7170
(901) 365-9712
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD36947
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD36947
MEDICAL LICENSE
TN
Enumeration date
08/27/2014
Last updated
08/27/2014
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