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General NPI Number Information
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NPI Number | 1750165536
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Entity Type | Individual
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Provider Name | MYA BAKER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 100 CALLEN BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2807
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Country | US
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Telephone | 854-529-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 571 CROSS PARK LN
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8299
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Country | US
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Telephone | 605-490-3650
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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 | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 42536
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License Number State | SC
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