MEDICARE: DR. DALE 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	207RR0500X	Rheumatology Physician	4301024290	MI

General Provider Information

NPI Number	:	1366407413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE E BAKER MD

Provider Business Mailing Address
First Line	:	3145 W CLARK RD
Second Line	:	STE 401
City	:	YPSILANTI
State	:	MI
Zip	:	48197-1120
Country	:	US
Telephone Number	:	734-528-5700
Fax Number	:	734-528-5701

Provider Business Practice Location Address
First Line	:	3145 W CLARK RD
Second Line	:	STE 401
City	:	YPSILANTI
State	:	MI
Zip	:	48197-1120
Country	:	US
Telephone Number	:	734-528-5700
Fax Number	:	734-528-5701

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/20/2014

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