Provider Demographics
NPI:1144220575
Name:BAKER, ROBERT E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:E
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3206 CHURCHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5206
Mailing Address - Country:US
Mailing Address - Phone:757-484-0101
Mailing Address - Fax:757-484-0515
Practice Address - Street 1:3206 CHURCHLAND BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5206
Practice Address - Country:US
Practice Address - Phone:757-484-0101
Practice Address - Fax:757-484-0515
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019198207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA25061OtherOPTIMA HEALTH CARE
VA205471OtherUHC
VA325041OtherMAMSI
VA1470973OtherCIGNA
VA4004544OtherAETNA
VA463163OtherANTHEM BCBS
VA890505AMedicaid
VA1470973OtherCIGNA