Provider Demographics
NPI:1013011303
Name:BAKER, STEPHEN W (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:W
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1051 GAUSE BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:SLIDEL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-641-7577
Practice Address - Fax:985-643-0826
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA321454207RC0000X, 207RX0202X, 207R00000X
MS12640208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0012038Medicaid
MS12640OtherSTATE LICENSE
MS060000233Medicare ID - Type Unspecified