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NPI Code Detail

MEDICARE: GARY L. BAKER MD

MEDICARE: GARY L. 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
1207RR0500XRheumatology Physician25221MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932168036
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY L. BAKER MD
Provider Business Mailing Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-262-5000
Fax Number : 612-262-4258
Provider Business Practice Location Address
First Line : 255 SMITH AVE N
Second Line : SUITE 100
City : SAINT PAUL
State : MN
Zip : 55102-2572
Country : US
Telephone Number : 651-241-5000
Fax Number : 651-241-7678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 11/04/2020

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