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General NPI Number Information
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NPI Number | 1578628368
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Entity Type | Individual
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Provider Name | MICHAEL M BAKERMAN M.D., F.A.C.C.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 736 CAMBRIDGE ST ADMINISTRATION
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City | BRIGHTON
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State | MA
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Zip | 02135-2907
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Country | US
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Telephone | 617-789-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 117 MANOMET AVE
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City | HULL
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State | MA
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Zip | 02045-2327
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Country | US
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Telephone | 781-608-6534
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 48876
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48876
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 48876
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License Number State | MA
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