Individual
DR. JOHN MARK BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N FANT ST, ANDERSON, SC 29621-5704
(864) 512-2000
(864) 512-8492
Mailing address
600 N FANT ST, ANDERSON, SC 29621-5704
(864) 512-2000
(864) 512-8492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12896
SC
207Q00000X
Family Medicine Physician
13844
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080112826
MEDICAID
GA
05
—
12896
—
SC
05
—
128962
—
SC
01
—
P01487648
RR MEDICARE
SC
01
—
S376900
RAILROAD MEDICARE
—
Enumeration date
06/08/2006
Last updated
09/15/2015
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