Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 283673-1 | NY |
N | 208200000X | Surgeon | 283973-1 | NY |
N | 208600000X | Surgeon | 283973-1 | NY |
NPI | 1083909543 |
---|---|
Provider Name | Dr. Shaun Sebastian Baker |
First Address | Williamsville, NY 14221-5782 |
Second Address | Williamsville, NY 14221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 02/12/2021 |