Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 059597 | GA |
NPI | 1467532523 |
---|---|
Provider Name | Constance Baldwin |
First Address | Atlanta, GA 30342-4794 |
Second Address | Atlanta, GA 30342-4794 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 14/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
754666400A | (05) | GA |