Provider Demographics
NPI:1033159074
Name:BALDWIN, CHRISTOPHER R (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14230 NW BURTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-4329
Mailing Address - Country:US
Mailing Address - Phone:503-781-9840
Mailing Address - Fax:503-726-1039
Practice Address - Street 1:6200 N. LACHOLLA BLVD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85755
Practice Address - Country:US
Practice Address - Phone:520-742-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR026491Medicaid
ORP00362643OtherRR MEDICARE
ORR160581Medicare PIN
ORR154811Medicare PIN
OR026491Medicaid
ORR154810Medicare PIN
ORR158863Medicare PIN
ORR135992Medicare PIN
ORR144731Medicare PIN