Provider Demographics
NPI:1922101351
Name:BAKER, DONALD JOHN (MD)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOHN
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 BRICK RD STE 306
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2146
Mailing Address - Country:US
Mailing Address - Phone:856-596-0111
Mailing Address - Fax:856-596-7194
Practice Address - Street 1:100 BRICK RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2146
Practice Address - Country:US
Practice Address - Phone:856-596-0111
Practice Address - Fax:856-782-8227
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06217400207NP0225X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1345833OtherUNITED HEALTHCARE
MA678471OtherHIGHMARK BCBS
NJ0443337000OtherKEYSTONE HEALTHPLAN
NJ0443337000OtherAMERIHEALTH
1315787OtherMAILHANDLERS
070013748OtherRR MEDICARE
150196OtherPREFERRED HEALTH NETWORK (PHN)
NJ2145889OtherAETNA HMO
P1845476OtherOXFORD
0804249000OtherINDEPENDENT BCBS
NJ5030223OtherAETNA PPO
1345833OtherUNITED HEALTHCARE
NJ779902Medicare PIN