Individual
KEVIN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSCIAL THERAPIST
Contact information
Practice address
55 BAXTER BLVD, PORTLAND, ME 04101-1801
(207) 773-7428
(207) 842-6229
Mailing address
55 BAXTER BLVD, PORTLAND, ME 04101-1801
(207) 773-7428
(207) 842-6229
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
269113
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061426
ANTHEM
ME
Enumeration date
07/06/2007
Last updated
07/08/2007
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