MEDICARE: SHERMAINE BAKER PT, DPT

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	225100000X	Physical Therapist	2552	AK

General Provider Information

NPI Number	:	1780021303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERMAINE BAKER PT, DPT

Provider Business Mailing Address
First Line	:	1755 WITTINGTON PL
Second Line	:	SUITE 800
City	:	DALLAS
State	:	TX
Zip	:	75234-1927
Country	:	US
Telephone Number	:	214-442-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 WITTINGTON PL
Second Line	:	SUITE 800
City	:	DALLAS
State	:	TX
Zip	:	75234-1927
Country	:	US
Telephone Number	:	214-442-4000
Fax Number	:

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

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	08/07/2014

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