Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1100X | Ophthalmic | 156FX1100X | NC |
NPI | 1760605034 |
---|---|
Provider Name | Mr. Mark Steven Baker |
First Address | Hickory, NC 28601-7090 |
Second Address | Conover, NC 28613-8201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |