Healthcare Provider Details

I. General information

NPI: 1609453737
Provider Name (Legal Business Name): WESLEY BAKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 UNION AVE STE 167
DOVER OH
44622-3005
US

IV. Provider business mailing address

515 UNION AVE STE 167
DOVER OH
44622-3005
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-3335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34.017298
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: