Provider Demographics
NPI:1871544379
Name:BAKER, MICHELE S (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:S
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 WASHINGTON ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6874
Mailing Address - Country:US
Mailing Address - Phone:617-365-1738
Mailing Address - Fax:
Practice Address - Street 1:370 WASHINGTON ST
Practice Address - Street 2:SUITE #3
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6874
Practice Address - Country:US
Practice Address - Phone:617-365-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1603022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry