Organization
DERMATOLOGY REALM AND FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM W. BAKER MD (MEMBER)
(901) 362-7170
Entity
Organization
Contact information
Practice address
2120 MERCHANTS ROW STE 2, GERMANTOWN, TN 38138-0806
(901) 362-7170
(901) 365-9712
Mailing address
2120 MERCHANTS ROW STE 2, GERMANTOWN, TN 38138-0806
(901) 362-7170
(901) 365-9712
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD36947
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD36947
MEDICAL LICENSE
TN
Enumeration date
08/27/2014
Last updated
08/27/2014
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