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General NPI Number Information
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NPI Number | 1508194978
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Entity Type | Organization
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Legal Business Name | PODIATRY PRACTICE HELPERS
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 330 N WABASH AVE STE 460A
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City | MARION
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State | IN
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Zip | 46952-2696
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Country | US
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Telephone | 765-382-4957
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Fax | 765-382-4958
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Provider Business Mailing Address
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Address Line | PO BOX 330
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City | FORTVILLE
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State | IN
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Zip | 46040-0330
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Country | US
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Telephone | 317-863-2556
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Fax | 317-203-0420
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MICHAEL JAMES BAKER
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Credential | DPM
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Telephone | 317-863-2556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246YC3302X
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Taxonomy Name | Physician Office Based Coding Specialist
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License Number | 659635
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License Number State | IN
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