Basic Information
| Provider Information | |||||||||
| NPI: | 1922028596 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | HAL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BAKER | ||||||||
| OtherFirstName: | R. | ||||||||
| OtherMiddleName: | HAL | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177418003 | ||||||||
| FaxNumber: | 7177418016 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 MONUMENT RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177418003 | ||||||||
| FaxNumber: | 7174617404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD048676L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 011082 | 01 | PA | JOHNS HOPKINS | OTHER | 233280 | 01 | PA | MAMSI-WMG | OTHER | 528195 | 01 | MD | CAREFIRST MD BCBS | OTHER | 689613 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 81794 | 01 | PA | UNISON-WMG | OTHER | 1142279 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 93653 | 01 | PA | GEISINGER | OTHER | P002842 | 01 | PA | GATEWAY-WMG | OTHER | 01060401 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 5927077 | 01 | PA | AETNA | OTHER | 001516998 | 05 | PA | MEDICAID | 0792013000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 110114832 | 01 | PA | RAILROAD MEDICARE | OTHER |