Provider Demographics
NPI:1144290958
Name:BAKER, DANIEL L (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 GOLF COURSE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3526
Mailing Address - Country:US
Mailing Address - Phone:218-326-8749
Mailing Address - Fax:218-326-0400
Practice Address - Street 1:111 GOLF COURSE RD
Practice Address - Street 2:STE 1
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3526
Practice Address - Country:US
Practice Address - Phone:218-326-8749
Practice Address - Fax:218-326-0400
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46517207X00000X, 207XS0106X, 207XX0004X, 207XX0005X, 207XX0801X
MN45617207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Not Answered207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Not Answered207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Not Answered207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0901369OtherMEDICA
MN982221041071OtherPREFERRED ONE
MNP00142690OtherRAILROAD MEDICARE
MNHP49325OtherHEALTH PARTNERS
MN131651OtherU CARE
MN268L3BAOtherBCBS
MNNO10804OtherCHAMPUS
MNNO10804OtherCHAMPUS