Healthcare Provider Details

I. General information

NPI: 1912832452
Provider Name (Legal Business Name): PAUL BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3829 WOODLEY RD STE B6
TOLEDO OH
43606-1174
US

IV. Provider business mailing address

1775 BAIRSFORD CIR W
COLUMBUS OH
43232-3003
US

V. Phone/Fax

Practice location:
  • Phone: 419-690-4544
  • Fax:
Mailing address:
  • Phone: 614-323-9433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: