Provider Demographics
NPI:1184974982
Name:BAKER, MEGAN ELIZABETH (DPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BAKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WHEATON DR
Mailing Address - Street 2:
Mailing Address - City:LITTLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17340-1356
Mailing Address - Country:US
Mailing Address - Phone:717-926-4627
Mailing Address - Fax:
Practice Address - Street 1:1502 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5325
Practice Address - Country:US
Practice Address - Phone:301-829-5880
Practice Address - Fax:301-829-5889
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1184974982Medicaid