Individual
CHARLOTTE L BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 N 26TH ST, SUITE 201, LAFAYETTE, IN 47904-2856
(765) 446-6535
Mailing address
415 N 26TH ST, SUITE 201, LAFAYETTE, IN 47904-2856
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01066919A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA08434500
STATE MEDICAL LICENSE
NJ
Enumeration date
07/21/2008
Last updated
10/05/2012
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