Provider Demographics
NPI:1588610638
Name:BAKER, JOEL W (DO)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:W
Last Name:BAKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9469
Mailing Address - Country:US
Mailing Address - Phone:610-378-3782
Mailing Address - Fax:610-378-2980
Practice Address - Street 1:2500 BERNVILLE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9453
Practice Address - Country:US
Practice Address - Phone:610-378-2899
Practice Address - Fax:610-378-2980
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012783207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABA1845688OtherHIGHMARK BLUE SHIELD
PA1027545110001Medicaid
PA101056Medicare PIN