Individual
MARTIN P BAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 FISHER RD, BERLIN, VT 05602-9516
(802) 371-4100
Mailing address
130 FISHER RD, PO BOX 547, BERLIN, VT 05602-9516
(802) 371-4100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042-0010642
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009985
—
VT
Enumeration date
07/13/2006
Last updated
07/08/2007
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