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NPI Code Detail

MEDICARE: MR. THOMAS R BAKER HIS

MEDICARE: MR. THOMAS R BAKER HIS
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
1237700000XHearing Instrument Specialist438SC

General Provider Information

NPI Number : 1194950717
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS R BAKER HIS
Provider Business Mailing Address
First Line : 1565 SAM RITTENBERG BLVD
Second Line : SUITE 100
City : CHARLESTON
State : SC
Zip : 29407-4138
Country : US
Telephone Number : 843-571-0744
Fax Number : 843-571-0743
Provider Business Practice Location Address
First Line : 1565 SAM RITTENBERG BLVD
Second Line : SUITE 100
City : CHARLESTON
State : SC
Zip : 29407-4138
Country : US
Telephone Number : 843-571-0744
Fax Number : 843-571-0743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 05/27/2009

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