Individual
DR. MARY S BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5801 BREMO RD # 209, RICHMOND, VA 23226-1907
(804) 281-8210
(804) 410-4616
Mailing address
1419 N VEAUX LOOP, NORFOLK, VA 23509-1259
(757) 353-8122
(757) 261-0173
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01067684
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101257165
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2023-1245
NM
207RP1001X
Pulmonary Disease Physician
Primary
0101257165
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000710972
ANTHEM PIN
IN
05
—
1932360450
—
VA
05
—
201020340
—
IN
Enumeration date
06/17/2008
Last updated
01/21/2025
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