Provider Demographics
NPI:1740758531
Name:BAKER, MARY MARGARET (PA-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:125 INDIAN ROCK RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2008
Practice Address - Country:US
Practice Address - Phone:603-890-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2023-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH1415363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical