Provider Demographics
NPI:1295964336
Name:BAKER, RYAN (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 OPOSSUMTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4673
Mailing Address - Country:US
Mailing Address - Phone:301-631-2013
Mailing Address - Fax:301-631-2148
Practice Address - Street 1:1595 OPOSSUMTOWN PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4673
Practice Address - Country:US
Practice Address - Phone:301-631-2013
Practice Address - Fax:301-631-2148
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443586183500000X
MD19375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist