Baker Suraj, Inc

Organization Active NPI Internal Medicine Physician · New Iberia, LA

NPI 1487956538 · NPPES record last updated Nov 23, 2010

Key facts

NPI
1487956538
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
023492 (LA)
Legal business name
BAKER SURAJ, INC
Practice address
602 N. Lewis Ave.
Suite 100
New Iberia, LA 70563
Phone
(337) 364-2822
Fax
(337) 364-1978
NPI assigned
Nov 23, 2010
Organization subpart
Yes
Parent organization (as reported)
BAKER SURAJ, INC.

Authorized official

Name
Vina S. Baker
Title
Physician/Medical Director
Phone
(337) 364-2822

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101201000698 LA Part B Supplier - Clinic/Group Practice 2365638434 Receives reassigned benefits from 1 practitioner
Practice locations: New Iberia, LA

National Provider Directory

Part of
Bakersuraj Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 023492 LA Yes

Addresses

Primary practice location

602 N. Lewis Ave.
Suite 100
New Iberia, LA 70563

Mailing address

602 N. Lewis Ave.
Suite 100
New Iberia, LA 70563
Phone (337) 364-2822

Other identifiers

IdentifierTypeStateIssuer
1482030MedicaidLA

Other providers in New Iberia, LA

All providers in New Iberia, LA · Internal Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.