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Individual

MARTY ALLEN BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
705 SUMMIT CROSSING PL, SUITE 150, GASTONIA, NC 28054-2137
(704) 671-5300
(704) 671-6307
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200000009
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1292W
BCBSNC
NC
01
237446783
BCBSSC
SC
05
891292W
NC
01
N00009
SC MEDICAID
SC
Enumeration date
07/27/2006
Last updated
02/28/2023
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