Provider Demographics
NPI:1114920121
Name:BAKER, RICHARD E JR (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 PLEASANT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-646-7720
Mailing Address - Fax:508-646-7721
Practice Address - Street 1:68 CAMP ST STE 2
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3048
Practice Address - Country:US
Practice Address - Phone:774-470-4507
Practice Address - Fax:774-810-7189
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRIDPM265213ES0103X
MA1924213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI403424OtherRI BLUE CHIP
RI4100731001OtherCIGNA
RI27507OtherNEIGHBORHOOD HEALTH
RI480033069OtherRAILROAD MEDICARE
RI2700472OtherUNITED HEALTHCARE
RI9007074Medicaid
RI453013OtherTUFTS
RI0000023116OtherRI BLUE CROSS
RI2301915OtherAETNA US HEALTHCARE
RI0000023116OtherRI BLUE CROSS
RI27507OtherNEIGHBORHOOD HEALTH