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General NPI Number Information
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NPI Number | 1275696635
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Entity Type | Organization
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Legal Business Name | R G BAKER DO PC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 7226 ALLEN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-2060
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Country | US
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Telephone | 313-383-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 7226 ALLEN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-2060
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Country | US
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Telephone | 313-383-5530
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD G BAKER
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Credential | D.O.
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Telephone | 313-383-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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