Individual
MR. RYAN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6 RICHLAND MEDICAL PARK DR STE 2100, COLUMBIA, SC 29203
(803) 434-2762
Mailing address
112 SALUDA RIDGE CT, STE 200, WEST COLUMBIA, SC 29169-3461
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
19325
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
19325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3818
—
SC
Enumeration date
02/25/2015
Last updated
03/20/2020
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