Provider Demographics
NPI:1740758531
Name:BAKER, MARY MARGARET (PA-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:BAKER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2551
Mailing Address - Country:US
Mailing Address - Phone:603-224-3368
Mailing Address - Fax:603-228-7268
Practice Address - Street 1:264 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2551
Practice Address - Country:US
Practice Address - Phone:603-224-3368
Practice Address - Fax:603-228-7268
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1415363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical