Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 4301093463 | MI |
NPI | 1013150143 |
---|---|
Provider Name | Andrew James Baldock |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2009 |
Last Update Date | 20/04/2009 |