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NPI Code Detail

MEDICARE: ELIZABETH WALLACE BAKER MD

MEDICARE: ELIZABETH WALLACE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1457033995
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH WALLACE BAKER MD
Provider Business Mailing Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5812
Country : US
Telephone Number : 704-355-3181
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5812
Country : US
Telephone Number : 704-355-3181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2023
Last Update Date : 12/15/2025

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Directions to “ ELIZABETH WALLACE BAKER MD” Practice Location

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