Provider Demographics
NPI:1265590947
Name:BAKER, ROBB J
Entity type:Individual
Prefix:
First Name:ROBB
Middle Name:J
Last Name:BAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2161
Mailing Address - Country:US
Mailing Address - Phone:440-888-6979
Mailing Address - Fax:440-888-6280
Practice Address - Street 1:5810 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-2161
Practice Address - Country:US
Practice Address - Phone:440-888-6979
Practice Address - Fax:440-888-6280
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH666840OtherUNITED HEALTH CARE
OH000000218581OtherANTHEM
OH000000218581OtherANTHEM
OH666840OtherUNITED HEALTH CARE