Provider Demographics
NPI:1003897497
Name:BAKER, JOSHUA STEVEN (PAC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:STEVEN
Last Name:BAKER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:WV
Mailing Address - Zip Code:26451-6801
Mailing Address - Country:US
Mailing Address - Phone:304-745-4568
Mailing Address - Fax:304-326-3700
Practice Address - Street 1:597 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:WV
Practice Address - Zip Code:26451-6801
Practice Address - Country:US
Practice Address - Phone:304-745-4568
Practice Address - Fax:304-326-3700
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV862363A00000X
WV468363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00414442OtherRAILROAD MEDICARE
WVWV862OtherHEALTH PLAN
WV001832689OtherMOUNTAIN STATE BCBS
WV001832689OtherMOUNTAIN STATE BCBS
WVPA22168Medicare PIN
WVPA22167Medicare PIN
WVWV862OtherHEALTH PLAN
WVMB1355329OtherDEA
WVQ08627Medicare UPIN
WVPA22166Medicare PIN
WVP00414442OtherRAILROAD MEDICARE
WVBAPA22162Medicare PIN