Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 32812 | NE |
N | 207SG0201X | Clinical Genetics (M.D.) | A162513 | CA |
NPI | 1003203779 |
---|---|
Provider Name | Dr. Craig Vech Baker |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68131-3707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 10/02/2021 |