Individual
BENNIE L BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2314
(843) 777-5035
Mailing address
PO BOX 100567, FLORENCE, SC 29506-2617
(843) 777-2314
(843) 777-5035
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TL29634
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296343
—
SC
Enumeration date
07/28/2005
Last updated
10/05/2007
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