Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 7025 | AL |
Y | 2086S0120X | Pediatric Surgery | M3884 | TX |
NPI | 1104820554 |
---|---|
Provider Name | Dr. Charles Eugene Baldwin |
First Address | San Antonio, TX 78258-4298 |
Second Address | San Antonio, TX 78258-4298 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000009542 | (05) | AL |
051009542 | BLUE CROSS (01) | AL |
096153100 | (05) | FL |
1710246 | UNITED HEALTHCARE (01) | AL |
183103401 | (05) | TX |
4041476 | (05) | TN |
51009542BAL | VIVA HEALTH (01) | AL |
C70579 | (02) | AL |