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General NPI Number Information
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NPI Number | 1215160734
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Entity Type | Individual
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Provider Name | SAMUEL W BAKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 3900 WOODLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4551
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Country | US
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Telephone | 215-823-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 7 WELWYN RD WAYNE
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City | WAYNE
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State | PA
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Zip | 19087-3881
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Country | US
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Telephone | 610-888-4731
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MT194975
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD444539
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License Number State | PA
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