MEDICARE: GREGORY E BAKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	119352	MO
2	207Q00000X	Family Medicine Physician	ME131352	FL

General Provider Information

NPI Number	:	1083654206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY E BAKER MD

Provider Business Mailing Address
First Line	:	4140 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3494
Country	:	US
Telephone Number	:	727-953-9041
Fax Number	:	727-953-9043

Provider Business Practice Location Address
First Line	:	4140 WOODLANDS PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3494
Country	:	US
Telephone Number	:	727-953-9041
Fax Number	:	727-953-9043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/21/2022

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