Individual
CHARLES MICHAEL BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Mailing address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
167130
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052431
—
NC
01
—
P00299154
RAILROAD-MEDICARE
NC
Enumeration date
01/23/2007
Last updated
03/12/2021
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