Organization
MICHAEL L BAKER DO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L BAKER D.O. (SINGLE MEMBER/OWNER)
(812) 254-2400
Entity
Organization
Contact information
Practice address
1401 MEMORIAL AVE, SUITE B, WASHINGTON, IN 47501-3153
(812) 254-2400
(812) 254-3191
Mailing address
1401 MEMORIAL AVE, SUITE B, WASHINGTON, IN 47501-3153
(812) 254-2400
(812) 254-3191
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02002933A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383679
BLUE CROSS/BLUE SHIELD
IN
05
—
201042640A
—
IN
Enumeration date
08/19/2011
Last updated
08/28/2012
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