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Individual

DR. JUSTIN K BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D,

Contact information

Practice address
4045 E BELL RD, STE #143, PHOENIX, AZ 85032-2236
(602) 867-0404
(602) 788-0893
Mailing address
4045 E BELL RD, STE #143, PHOENIX, AZ 85032-2236
(602) 867-0404
(602) 788-0893

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33732
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
975162
AZ
01
AZ0153720
BLUE CROSS BLUE SHIELD
AS
Enumeration date
05/25/2006
Last updated
01/13/2011
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