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1508861287

NPI Code Detail

MEDICARE: THEODORE D BAKER MD

MEDICARE: THEODORE D 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	2085R0202X	Diagnostic Radiology Physician	2026017103	MO
2	2085R0202X	Diagnostic Radiology Physician	22759	AL
3	2085R0202X	Diagnostic Radiology Physician	81489	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051522427	OTHER	AL	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	051515362	OTHER	AL	BLUE CROSS
5	051522678	OTHER	AL	BLUE CROSS
6	051525486	OTHER	AL	BLUE CROSS
7	515-22683	OTHER	AL	BLUE CROSS
8	051522677	OTHER	AL	BLUE CROSS
9	051522686	OTHER	AL	BLUE CROSS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	051539832	OTHER	AL	BLUE CROSS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	7070599	OTHER	AL	AETNA
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	051522679	OTHER	AL	BLUE CROSS
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	051522684	OTHER	AL	BLUE CROSS
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	051522681	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1508861287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THEODORE D BAKER MD

Provider Business Mailing Address
First Line	:	2000A SOUTHBRIDGE PKWY STE 300
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-7718
Country	:	US
Telephone Number	:	205-871-4274
Fax Number	:	205-871-4301

Provider Business Practice Location Address
First Line	:	50 MEDICAL PARK DR E
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3401
Country	:	US
Telephone Number	:	205-838-3435
Fax Number	:

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	05/18/2026

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Directions to “ THEODORE D BAKER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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