MEDICARE: DR. ALFREDO ERNESTO BAKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	2021-03158	NC

General Provider Information

NPI Number	:	1407823420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDO ERNESTO BAKER M.D.

Provider Business Mailing Address
First Line	:	39 OFFICE PARK DR STE A
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-3220
Country	:	US
Telephone Number	:	910-939-0724
Fax Number	:	910-333-9145

Provider Business Practice Location Address
First Line	:	39 OFFICE PARK DR STE A
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-3220
Country	:	US
Telephone Number	:	910-939-0724
Fax Number	:	910-333-9145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	12/14/2022

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