Provider Demographics
NPI:1588267207
Name:BAKER, MICHAEL BRIAN (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:BAKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 MIDDLETOWN ODESSA RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8964
Mailing Address - Country:US
Mailing Address - Phone:302-378-2287
Mailing Address - Fax:302-378-4415
Practice Address - Street 1:674 MIDDLETOWN ODESSA RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8964
Practice Address - Country:US
Practice Address - Phone:302-378-2287
Practice Address - Fax:302-378-4415
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist