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General NPI Number Information
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NPI Number | 1679689467
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Entity Type | Individual
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Provider Name | KENNETH BAKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 625 AFRICA RD STE 200
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City | WESTERVILLE
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State | OH
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Zip | 43082-9808
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Country | US
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Telephone | 614-714-0985
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Fax | 614-714-0986
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Provider Business Mailing Address
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Address Line | 625 AFRICA RD STE 200
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City | WESTERVILLE
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State | OH
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Zip | 43082-9808
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Country | US
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Telephone | 614-714-0985
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Fax | 614-714-0986
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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 | 35067314
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License Number State | OH
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