1275782138 NPI number — DR. TAMARA LEIGH BAKER PH.D.

Table of content: JEFFREY K KOBS MD (NPI 1124021951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275782138 NPI number — DR. TAMARA LEIGH BAKER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAKER
Provider First Name:
TAMARA
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275782138
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 STODDARD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPARKS GLENCOE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21152-9367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-471-3557
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2650 QUARRY LAKE DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21209-3756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-757-2077
Provider Business Practice Location Address Fax Number:
410-757-5184
Provider Enumeration Date:
09/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  03175 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0381926 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3293755 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 128463 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 203301 . This is a "VALUEOPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 99550316 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: C9RQTL . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 600697029 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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