MEDICARE: DR. EVELYN LOUISE 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	207W00000X	Ophthalmology Physician	0101234244	VA

General Provider Information

NPI Number	:	1518973528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELYN LOUISE BAKER M.D.

Provider Business Mailing Address
First Line	:	8401 N RUN MEDICAL DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2309
Country	:	US
Telephone Number	:	804-769-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 N RUN MEDICAL DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2309
Country	:	US
Telephone Number	:	804-769-2020
Fax Number	:	804-999-0455

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	12/16/2022

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