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General NPI Number Information
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NPI Number | 1649851759
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Entity Type | Individual
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Provider Name | ANGELA MARIE MASSOUD BAKER DO
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Gender | Female
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 335 SCHOOL ST
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City | CLEVELAND
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State | NC
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Zip | 27013-9501
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Country | US
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Telephone | 704-210-7885
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Fax | 704-210-7898
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2023-03148
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MASS-BNFV19
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License Number State | NC
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