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NPI Code Detail

MEDICARE: CHARITY DARA BAKER DO

MEDICARE: CHARITY DARA BAKER DO
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
1207P00000XEmergency Medicine Physician02003107AIN
2207Q00000XFamily Medicine Physician02003107AIN
3207Q00000XFamily Medicine Physician4009IA

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 : 1982820866
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARITY DARA BAKER DO
Provider Business Mailing Address
First Line : 705 ELM ST E
Second Line :
City : ROCKWELL
State : IA
Zip : 50469-1035
Country : US
Telephone Number : 641-372-0315
Fax Number : 641-372-0304
Provider Business Practice Location Address
First Line : 705 ELM ST E
Second Line :
City : ROCKWELL
State : IA
Zip : 50469-1035
Country : US
Telephone Number : 641-372-0315
Fax Number : 641-372-0304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 01/10/2019

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Directions to “ CHARITY DARA BAKER DO” Practice Location

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