Healthcare Provider Details

I. General information

NPI: 1669811527
Provider Name (Legal Business Name): KEITH ALAN BAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST DEPT OF EMERGENCY MEDICINE
BETHLEHEM PA
18015
US

IV. Provider business mailing address

801 OSTRUM ST DEPT OF EMERGENCY MEDICINE
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-4500
  • Fax:
Mailing address:
  • Phone: 866-785-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD455818
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberMD455818
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: