Individual
AMANDA MARIE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200401209
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346454881
—
VA
01
—
147CE
BCBS
—
01
—
201079
MEDCOST
—
05
—
3810009477
—
WV
05
—
5906909
—
NC
01
—
810618
PARTNERS
—
01
—
9905110
AETNA
—
05
—
Q0120E
—
SC
Enumeration date
05/10/2007
Last updated
05/24/2023
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