Individual
DR. JEREMY RONALD BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19 WOODLAND ST STE 23, HARTFORD, CT 06105-2368
(860) 522-2251
(860) 493-2552
Mailing address
189 KEARSARGE VALLEY RD, WILMOT, NH 03287-4706
(603) 359-8107
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/15/2019
Last updated
05/12/2022
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