Dr. Sam Baker, OD
Optometrist in Springfield, VA. Individual provider (NPI-1).
NPI number1992887798
StatusActive
Last updated in NPPESMay 28, 2021
Details
- NPI
- 1992887798
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sam Baker
- Credential
- OD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 20, 2006
- Certification date
- May 28, 2021
- Last updated
- May 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 0618002372 | VA | Yes |
Practice location
6535 Springfield MallSpace # 11045
Springfield, VA 22150-1714
Phone 703-971-4739
Mailing address
9127 Cricklewood CtVienna, VA 22182-1702
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