Healthcare Provider Details

I. General information

NPI: 1215158928
Provider Name (Legal Business Name): ARTHUR M. BAKER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 WATERS AVE SUITE 302
SAVANNAH GA
31404-6200
US

IV. Provider business mailing address

4750 WATERS AVE STE 302
SAVANNAH GA
31404-6268
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-5970
  • Fax: 912-350-3374
Mailing address:
  • Phone: 912-350-5970
  • Fax: 912-350-3374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number37169
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number065729
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier003110197D
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 2
IdentifierP00955088
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerRAILROAD MEDICARE
# 3
Identifier003110197C
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 4
Identifier003110197A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 5
Identifier613635
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerWELLCARE
# 6
IdentifierGA1206
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer
# 7
Identifier01441252
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERIGROUP
# 8
Identifier003110197B
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: