Individual
EARL LEWIN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 DIVISION STREET, DERBY, CT 06418
(203) 735-7421
Mailing address
591 WINGFOOT ROAD, ORANGE, CT 06477-2743
(203) 795-6540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
014213
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AB2383709
BNDD
—
Enumeration date
06/07/2007
Last updated
07/08/2007
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