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General NPI Number Information
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NPI Number | 1205495918
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Entity Type | Individual
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Provider Name | MICHELLE BAKER MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1500 N JAMES ST
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City | ROME
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State | NY
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Zip | 13440-2844
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Country | US
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Telephone | 315-338-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2005
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-4505
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Country | US
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Telephone | 315-449-0513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 330963
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License Number State | NY
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