BRUCE HENRY BAKER MD NPI 1952377566

NPI Information

NPI: 1952377566
Provider Name: BRUCE HENRY BAKER, MD
Classification: Family Medicine - 207QA0401X
Entity Type: Individual

Specialization: Addiction Medicine

Organization: NEWAYGO COUNTY MENTAL HEALTH BOARD

PECOS Registration: Yes

Address:
3210 EAGLE RUN DR
SUITE 200
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 957-1200
Get Directions

Bruce Henry Baker, MD is an addiction medicine family medicine in Grand Rapids, MI with 45 years of experience. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Bruce Henry Baker, MD NPI is 1952377566. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduation Year:1979

The provider's business location address is:

3210 EAGLE RUN DR
SUITE 200
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 957-1200
Fax: (616) 957-1297

The NPI 1952377566 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/23/2006 and was last updated on 6/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RA0401X	Internal Medicine	Addiction Medicine	100005	MICHIGAN	No
2	207QA0401X	Family Medicine	Addiction Medicine	100005	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	B46178	MEDICARE UPIN
2	4786146	MEDICAID	MICHIGAN
3	P14500002	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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