Provider Demographics
NPI:1548847692
Name:BAKER, JOSEPH MATTHEW (MD, MS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MATTHEW
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8414 NAAB RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1972
Mailing Address - Country:US
Mailing Address - Phone:317-338-6399
Mailing Address - Fax:317-338-6359
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-1972
Practice Address - Country:US
Practice Address - Phone:214-648-8826
Practice Address - Fax:214-648-9207
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program