Provider Demographics
NPI:1225465248
Name:BAKER, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 ROCKVILLE PIKE
Mailing Address - Street 2:BUILDING 10/1C351
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-594-6175
Mailing Address - Fax:
Practice Address - Street 1:9000 ROCKVILLE PIKE
Practice Address - Street 2:BUILDING 10/1C351
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-594-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD596822085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology