Individual
DR. CHARLES WESLEY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2888 W GRAND BLVD, DETROIT, MI 48202-2612
(313) 875-5738
(313) 664-0811
Mailing address
7700 2ND AVE, DETROIT, MI 48202-2411
(313) 875-5738
(313) 875-5728
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
430 103 9100
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2768354
—
MI
Enumeration date
10/25/2006
Last updated
07/08/2007
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