Provider Demographics
NPI:1699077081
Name:BAKER, SUSAN M (DSC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:DSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7407 FORESTS EDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9428
Mailing Address - Country:US
Mailing Address - Phone:410-813-2070
Mailing Address - Fax:
Practice Address - Street 1:7407 FORESTS EDGE CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-9428
Practice Address - Country:US
Practice Address - Phone:410-813-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15906225100000X, 2251G0304X, 2251H1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors