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Individual

RANDAL BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2060 E PARIS AVE SE, SUITE 100, GRAND RAPIDS, MI 49546-6113
(616) 956-6100
(616) 956-6637
Mailing address
2060 E PARIS AVE SE, SUITE 100, GRAND RAPIDS, MI 49546-6113
(616) 956-6657
(616) 956-6637

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301057752
MI

Other

Enumeration date
06/09/2006
Last updated
06/28/2013
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