Individual
MR. BRIAN L BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
146 WILLIAMS DR, SPENCER, WV 25276-1826
(304) 927-1495
(304) 927-5813
Mailing address
146 WILLIAMS DR, SPENCER, WV 25276-1826
(304) 927-1495
(304) 927-5813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
356
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000867
—
WV
Enumeration date
06/02/2005
Last updated
08/17/2012
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