Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301054776 | MI |
N | 111NI0900X | Internist | 4301054776 | MI |
Y | 207RA0201X | Internist - Allergy & Immunology | 4301054776 | MI |
NPI | 1063501989 |
---|---|
Provider Name | James R Baker JR. |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 10/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2590710 | (05) | MI |
F00453 | (02) | MI |