person
Mr. Michael Russell Baker, PA
Surgical Physician Assistant in Omaha, Nebraska
NPI 1659346047

Michael Russell Baker is a Surgical Physician Assistant based in Omaha, NE and is specialized in Surgical. Michael Russell Baker practices in Omaha, NE and has the professional credentials of PA. The NPI Number for Michael Russell Baker is 1659346047 and holds a License No. 196 (Nebraska).

The current practice location address for Michael Russell Baker is 11704 W Center Rd, Omaha, NE and can be reached out via phone at 402-691-0500 and via fax at 402-505-6249.

Location: 11704 W Center Rd, Omaha, NE, 68144-4375
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Provider Profile Details
NPI Number
1659346047
Provider Name
Michael Russell Baker
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
11704 W Center Rd, Omaha, NE, 68144-4375
Phone Number
402-691-0500
Fax Number
402-505-6249
Provider Enumeration Date
02/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
196 01 NE NE PA LICENSE NMBR
R80756 01 IA IA BCBS PROVIDER NMBR
institution
Provider Business Practice Location Address Details
Address
11704 W Center Rd
City
State
Zip
68144-4375
Phone Number
402-691-0500
Fax Number
402-505-6249
person
Provider Business Mailing Address Details
Address
11704 W Center Rd
City
State
Zip
68144-4375
Phone Number
402-691-0500
Fax Number
402-505-6249
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
196 (Nebraska)
Definition
Definition to come...
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