Provider Information for 1447011499
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TIMOTHY PETER BAKER
Sex: Male
NPI: 1447011499
Last Updated: 2024-01-17
Certification Date: 2024-01-15
Certification Date: 2024-01-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1447011499 | ||||||||
| Enumeration Date | 2024-01-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 10001 PMB 378 SAIPAN, MP 96950 United States Phone: 670-788-6258 | Fax: | ||||||||
| Primary Practice Address | QP 10001 PMB 378 SAIPAN, MP 96950 United States Phone: 670-788-6258 | Fax: | ||||||||
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