Individual
DR. RUSSELL ANDREW BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
772 BITTERSWEET PL, EL PASO, TX 79922-2002
(575) 571-2931
Mailing address
772 BITTERSWEET PL, EL PASO, TX 79922-2002
(575) 571-2931
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
BP1-0025744
TX
207P00000X
Emergency Medicine Physician
Primary
M9143
TX
390200000X
Student in an Organized Health Care Education/Training Program
A144908
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202772401
—
TX
01
—
8BW498
BCBS
TX
01
—
P00802542
RAILROAD
TX
Enumeration date
09/15/2007
Last updated
05/17/2015
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