Healthcare Provider Details

I. General information

NPI: 1952303224
Provider Name (Legal Business Name): RAMON DAVID BAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 SMALE LN
KUNKLETOWN PA
18058-7187
US

IV. Provider business mailing address

142 SMALE LN
KUNKLETOWN PA
18058-7187
US

V. Phone/Fax

Practice location:
  • Phone: 407-310-8372
  • Fax:
Mailing address:
  • Phone: 407-310-8372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME0026641
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: