Provider Demographics
NPI:1396986279
Name:BAKER, JOHN HARRISON (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HARRISON
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 CRUTCHFIELD STREET
Mailing Address - Street 2:STE. B
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:757-221-8042
Mailing Address - Fax:757-221-8042
Practice Address - Street 1:400 CRUTCHFIELD STREET
Practice Address - Street 2:STE. B
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:757-221-8042
Practice Address - Fax:757-221-8042
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101040892207V00000X
NC19308207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology