Provider Demographics
NPI:1235105297
Name:BAKER, BETH A (MD, MPH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:360 SHERMAN STREET
Mailing Address - Street 2:SUITE 470 SPECIALISTS IN OEM,
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-209-6334
Mailing Address - Fax:651-201-6521
Practice Address - Street 1:360 SHERMAN STREET
Practice Address - Street 2:SUITE 470
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-209-6334
Practice Address - Fax:651-201-6521
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN28667207R00000X, 2083T0002X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D81537Medicare UPIN