Provider Demographics
NPI:1891591350
Name:BAKER, GUNNER SEAN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:GUNNER
Middle Name:SEAN
Last Name:BAKER
Suffix:
Gender:
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 ARCH BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:VA
Mailing Address - Zip Code:24280-3558
Mailing Address - Country:US
Mailing Address - Phone:276-971-3209
Mailing Address - Fax:
Practice Address - Street 1:339 ARCH BARRETT DR
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:VA
Practice Address - Zip Code:24280-3558
Practice Address - Country:US
Practice Address - Phone:276-971-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist