Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 0101040652 | VA |
Y | 207T00000X | Neurosurgeon | 22365 | NH |
N | 207T00000X | Neurosurgeon | L2123 | TX |
NPI | 1043262363 |
---|---|
Provider Name | Dr. Nevan George Baldwin |
First Address | Lebanon, NH 03756-0001 |
Second Address | Lebanon, NH 03756-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058349402 | (05) | TX |
8B4320 | BCBS (01) | TX |