Provider Demographics
NPI:1114230133
Name:BAKER, ERIN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:BAKER
Other - Last Name:NANNINGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:35111 DODGE PARK RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-3922
Mailing Address - Country:US
Mailing Address - Phone:586-978-8010
Mailing Address - Fax:586-978-9075
Practice Address - Street 1:35111 DODGE PARK RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-3922
Practice Address - Country:US
Practice Address - Phone:586-978-8010
Practice Address - Fax:586-978-9075
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine