Provider Demographics
NPI:1164441770
Name:BAKER, STEVEN EGAN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:EGAN
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 1:400 EAST THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-3500
Mailing Address - Fax:218-786-3513
Practice Address - Street 1:4212 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807-2737
Practice Address - Country:US
Practice Address - Phone:218-786-3500
Practice Address - Fax:218-786-3513
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40864208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN611818600Medicaid
G53651Medicare UPIN
MN611818600Medicaid