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Individual

DR. EDMOND LOWE BAKER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3306 W ROOSEVELT ST, PHOENIX, AZ 85009-3404
(602) 889-9401
(602) 889-9404
Mailing address
3306 W ROOSEVELT ST, PHOENIX, AZ 85009-3404
(602) 889-9401
(602) 889-9404

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
37240
AZ
207V00000X
Obstetrics & Gynecology Physician
Primary
37240
AZ
207V00000X
Obstetrics & Gynecology Physician
81650
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
238838
MASSACHUSETTS LICENSE
MA
01
37240
ARIZONA LICENSE
AZ
05
467843
AZ
Enumeration date
04/22/2008
Last updated
03/23/2022
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