Provider Demographics
NPI:1417470808
Name:BAKER, MORGAN ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:ANNE
Last Name:BAKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 JOHN R RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5859
Mailing Address - Country:US
Mailing Address - Phone:248-588-9300
Mailing Address - Fax:248-588-9917
Practice Address - Street 1:29350 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2011
Practice Address - Country:US
Practice Address - Phone:248-647-9790
Practice Address - Fax:248-901-1831
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005071152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist