Matthew James Baker, D.O.

Individual provider Active NPI Child & Adolescent Psychiatry Physician · Wpafb, OH

NPI 1609181510 · NPPES record last updated Jul 16, 2021

Key facts

NPI
1609181510
Entity type
Individual (NPI type 1)
Primary specialty
Child & Adolescent Psychiatry Physician 2084P0804X
License
926 (NE)
Practice address
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone
(937) 257-6877
Fax
(937) 656-1192
NPI assigned
Aug 16, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
926NEMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 926 NE Yes

Addresses

Primary practice location

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Mailing address

4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone (937) 257-6877

Other providers in Wpafb, OH

All providers in Wpafb, OH · Child & Adolescent Psychiatry Physician in Ohio

Sources for this page

Verify at the official NPI Registry.