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Individual
DR. JOHN MARK BAKER
Active
Individual
DR. JOHN MARK BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12896
SC
207Q00000X
Family Medicine Physician
13844
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080112826
MEDICAID
GA
05
—
12896
—
SC
05
—
128962
—
SC
01
—
P01487648
RR MEDICARE
SC
01
—
S376900
RAILROAD MEDICARE
—
Enumeration date
06/08/2006
Last updated
09/15/2015
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