MEDICARE: TAMELA BAKER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1851783625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMELA BAKER

Provider Business Mailing Address
First Line	:	318 PRINCETON WALK
Second Line	:
City	:	ADAIRSVILLE
State	:	GA
Zip	:	30103-2653
Country	:	US
Telephone Number	:	678-848-3481
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 PRINCETON WALK
Second Line	:
City	:	ADAIRSVILLE
State	:	GA
Zip	:	30103-2653
Country	:	US
Telephone Number	:	678-848-3481
Fax Number	:

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

Provider Enumeration Date	:	03/03/2015
Last Update Date	:	03/03/2015

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Directions to “ TAMELA BAKER ” Practice Location

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