Provider Demographics
NPI:1083761183
Name:BALDINGER, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:BALDINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3025 HAMAKER CT STE 101
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2229
Mailing Address - Country:US
Mailing Address - Phone:703-876-9630
Mailing Address - Fax:703-876-0163
Practice Address - Street 1:3025 HAMAKER CT STE 101
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2229
Practice Address - Country:US
Practice Address - Phone:703-876-9630
Practice Address - Fax:703-876-0163
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101039636207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006308902Medicaid
VA006308902Medicaid
VA00A565C65Medicare ID - Type Unspecified