Provider Demographics
NPI:1104416460
Name:BAKER, KIARA J (CCMA)
Entity type:Individual
Prefix:MS
First Name:KIARA
Middle Name:J
Last Name:BAKER
Suffix:
Gender:F
Credentials:CCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ALTMAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-8024
Mailing Address - Country:US
Mailing Address - Phone:912-755-4599
Mailing Address - Fax:
Practice Address - Street 1:10500 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1109
Practice Address - Country:US
Practice Address - Phone:877-225-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAP8B2T4C8207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology