Provider Demographics
NPI:1033193941
Name:BAKER, DANIEL M (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
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 1:838 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-3718
Mailing Address - Country:US
Mailing Address - Phone:740-452-9319
Mailing Address - Fax:740-452-9319
Practice Address - Street 1:7762 CHETWOOD CLOSE
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8850
Practice Address - Country:US
Practice Address - Phone:614-279-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012620392085R0202X
PAMD064391L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17123Medicaid
MD004035984Medicaid
PA1509635Medicaid
PA0018444600007Medicaid
PA217851OtherUPMC
PA1757994OtherHIGHMARK BLUE SHIELD
PA2423000000OtherPERSONAL CHOICE
PA217851OtherUPMC
PA17123Medicaid
PAP00263046Medicare PIN