| Terrance L Baker Md | |
|
5601 Loch Raven Blvd Baltimore MD 21239-2905 | |
| (410) 592-9889 | |
| (410) 592-8464 |
| Full Name | Terrance L Baker Md |
|---|---|
| Speciality | Family Medicine |
| Location | 5601 Loch Raven Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Terrance Lee Baker (OWNER) |
| Authorized Official Contact | 4105929889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terrance L Baker Md 7027 Mount Vista Rd Kingsville MD 21087-1331 Ph: (410) 592-9889 | Terrance L Baker Md 5601 Loch Raven Blvd Baltimore MD 21239-2905 Ph: (410) 592-9889 |
| NPI Number | 1154476091 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 04/18/2023 |
| Medicare PECOS PAC ID | 5799888996 |
|---|---|
| Medicare Enrollment ID | O20070308000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154476091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 313M00000X | Nursing Facility/intermediate Care Facility | D0058570 (Maryland) | Secondary |
| Provider Name | Terrance L Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073557906 PECOS PAC ID: 8628058211 Enrollment ID: I20040723000481 |
| Provider Name | Hana T Kelele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194078857 PECOS PAC ID: 8729336995 Enrollment ID: I20180803000802 |
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