Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 4301078361 | MI |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD28079 | OR |
NPI | 1144345463 |
---|---|
Provider Name | Dr. Charles Frederick Baker |
First Address | Portland, OR 97227 |
Second Address | Portland, OR 97227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 09/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006724 | (05) | OR |