Individual
SHAN R BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 1ST FLOOR TAUBMAN CTR RECP A, ANN ARBOR, MI 48109-5312
(734) 936-8051
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301038320
MI
207YS0123X
Facial Plastic Surgery Physician
4301038320
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1267168
—
MI
Enumeration date
10/05/2006
Last updated
11/28/2018
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