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NPI Code Detail

MEDICARE: MATTHEW BAKER

MEDICARE:   MATTHEW  BAKER
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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse28244116AIN

General Provider Information

NPI Number : 1598627911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW BAKER
Provider Business Mailing Address
First Line : 1338 N LASALLE ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46201-1416
Country : US
Telephone Number : 317-987-8212
Fax Number :
Provider Business Practice Location Address
First Line : 1338 N LASALLE ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46201-1416
Country : US
Telephone Number : 317-987-8212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2025
Last Update Date : 11/25/2025

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