Provider Demographics
NPI:1306838180
Name:BAKER, ROBERT LOVE II (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOVE
Last Name:BAKER
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1003 BELLEFONTAINE AVE STE 125
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1867
Practice Address - Country:US
Practice Address - Phone:419-998-8207
Practice Address - Fax:419-998-8216
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI007874207T00000X
PA0S-005472-L207T00000X
OH34.003216207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2395911Medicaid
OH000000993083OtherANTHEM
OH4411497OtherAETNA
OHP00332509OtherRAILROAD MEDICARE
OHP01651886OtherRR MCR
OH000000493311OtherANTHEM BLUE CROSS & BLUE
OH310823108026OtherCARESOURCE
OH737847OtherBUCKEYE COMMUNITY HEALTH
OH06323OtherPARAMOUNT ADVANTAGE
OH000000493311OtherANTHEM BLUE CROSS & BLUE