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General NPI Number Information
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NPI Number | 1699906792
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Entity Type | Individual
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Provider Name | KATIE M BAKER M.M.S., PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 2601 HOLME AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-2007
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Country | US
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Telephone | 215-335-0735
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Fax |
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Provider Business Mailing Address
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Address Line | 5008 DAVIS DR
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City | DOYLESTOWN
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State | PA
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Zip | 18902-1138
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Country | US
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Telephone | 215-266-2803
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA053899
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | OA002369
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License Number State | PA
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