Individual
JAYMIE LEIGH BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
714 N MICHIGAN ST, SOUTH BEND, IN 46601-1035
(574) 647-7477
Mailing address
3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 46635-1781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11014402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11014402A
RESIDENCY PERMIT #
IN
Enumeration date
06/13/2008
Last updated
06/13/2008
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