Provider Demographics
NPI:1841379930
Name:BAKER, DAVID CHARLES (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CHARLES
Last Name:BAKER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 ENOLA RD
Mailing Address - Street 2:APARTMENT A-3
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4659
Mailing Address - Country:US
Mailing Address - Phone:828-443-5339
Mailing Address - Fax:
Practice Address - Street 1:633 OLD LANDFILL RD
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-8420
Practice Address - Country:US
Practice Address - Phone:828-632-1331
Practice Address - Fax:828-632-1346
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100738363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC100738OtherMEDICAL LICENSE NUMBER