Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 47103 | CO |
N | 208000000X | Pediatrician | 47103 | CO |
NPI | 1295946176 |
---|---|
Provider Name | Peter Russell Baker II |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 01/10/2018 |