Earl Lewin Baker, MD

Individual provider Active NPI Internal Medicine Physician · Derby, CT

NPI 1265635148 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1265635148
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
014213 (CT)
Practice address
130 Division Street
Derby, CT 06418
Phone
(203) 735-7421
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014213CTMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 014213 CT Yes

Addresses

Primary practice location

130 Division Street
Derby, CT 06418

Mailing address

591 Wingfoot Road
Orange, CT 06477-2743
Phone (203) 795-6540

Other identifiers

IdentifierTypeStateIssuer
AB2383709OtherBNDD

Other providers in Derby, CT

All providers in Derby, CT · Internal Medicine Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.