Provider Demographics
NPI:1184658486
Name:BAKER, LOWELL HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:HOWARD
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 1:910 E 26TH ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4526
Mailing Address - Country:US
Mailing Address - Phone:612-879-0169
Mailing Address - Fax:612-879-9116
Practice Address - Street 1:910 E 26TH ST
Practice Address - Street 2:SUITE 425
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4526
Practice Address - Country:US
Practice Address - Phone:612-879-0169
Practice Address - Fax:612-879-9116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN172082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology