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General NPI Number Information
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NPI Number | 1356308134
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Entity Type | Individual
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Provider Name | CHARLES EDWIN BAKER JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 436 HOSPITAL DR STE 230
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City | LINVILLE
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State | NC
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Zip | 28646
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Country | US
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Telephone | 828-737-7711
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Fax | 828-737-7713
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | CROSSNORE
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State | NC
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Zip | 28616
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Country | US
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Telephone | 828-737-7711
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Fax | 828-737-7713
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18600
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License Number State | NC
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