Provider Demographics
NPI:1700968153
Name:BAKER, DEBORAH B (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:BAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 MAIN ROAD NORTH
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444
Mailing Address - Country:US
Mailing Address - Phone:207-945-4321
Mailing Address - Fax:207-990-3301
Practice Address - Street 1:638 MAIN ROAD NORTH
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444
Practice Address - Country:US
Practice Address - Phone:207-945-4321
Practice Address - Fax:207-990-3301
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
B0415OtherBLUE CROSS
5794128OtherAETNA
T31305Medicare UPIN
B0415OtherBLUE CROSS