Individual
TIM BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 FRANKLIN ST, WASHINGTON, MO 63090
(636) 239-2741
(636) 239-0194
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-6828
(314) 977-6777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
102932
MO
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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