Provider Demographics
NPI:1548247463
Name:BAKER, WILLIAM B (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:940 CENTRAL PARK DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8816
Mailing Address - Country:US
Mailing Address - Phone:970-870-1035
Mailing Address - Fax:970-870-1036
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:SUITE 290
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8816
Practice Address - Country:US
Practice Address - Phone:970-870-1035
Practice Address - Fax:970-870-1036
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO46055207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86657011Medicaid
KY64953326Medicaid
IN200093390Medicaid
OH0279185Medicaid
IN200093390Medicaid
KY64953326Medicaid
OH0279185Medicaid
COCOA104756Medicare PIN