Basic Information
| Provider Information | |||||||||
| NPI: | 1114920121 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.P.M. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 289 PLEASANT ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027213005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086467720 | ||||||||
| FaxNumber: | 5086467721 | ||||||||
| Practice Location | |||||||||
| Address1: | 289 PLEASANT ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027213005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086467720 | ||||||||
| FaxNumber: | 5086467721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 04/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | RIDPM265 | RI | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213ES0103X | 1924 | MA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0000023116 | 01 | RI | RI BLUE CROSS | OTHER | 403424 | 01 | RI | RI BLUE CHIP | OTHER | 453013 | 01 | RI | TUFTS | OTHER | 480033069 | 01 | RI | RAILROAD MEDICARE | OTHER | 2700472 | 01 | RI | UNITED HEALTHCARE | OTHER | 27507 | 01 | RI | NEIGHBORHOOD HEALTH | OTHER | 4100731001 | 01 | RI | CIGNA | OTHER | 2301915 | 01 | RI | AETNA US HEALTHCARE | OTHER | 9007074 | 05 | RI | MEDICAID |