Individual
RONALD L BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11123 PARKVIEW PLAZA DR, SUITE 101, FORT WAYNE, IN 46845-1707
(260) 422-7455
(260) 424-9356
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01031122A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000595611
ANTHEM
IN
05
—
200009050
—
IN
01
—
3013278
OH MEDICAID
IN
Enumeration date
07/19/2005
Last updated
03/25/2013
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