Provider Demographics
NPI:1407823420
Name:BAKER, ALFREDO ERNESTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:ERNESTO
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39 OFFICE PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-3220
Mailing Address - Country:US
Mailing Address - Phone:910-939-0724
Mailing Address - Fax:910-333-9145
Practice Address - Street 1:39 OFFICE PARK DR STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-3220
Practice Address - Country:US
Practice Address - Phone:910-939-0724
Practice Address - Fax:910-333-9145
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-031582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry