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Individual

CHAD BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12901 BRUCE B DOWNS BLVD, MDC 21, TAMPA, FL 33612-4742
(813) 974-4835
(813) 974-5621
Mailing address
12901 BRUCE B DOWNS BLVD, MDC 21, TAMPA, FL 33612-4742
(813) 974-4835
(813) 974-5621

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125-054586
IL
207W00000X
Ophthalmology Physician
Primary
ME112395
FL

Other

Enumeration date
06/19/2008
Last updated
06/25/2012
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