Provider Demographics
NPI:1114903861
Name:BALDY, GREGORY E (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:E
Last Name:BALDY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7154
Mailing Address - Country:US
Mailing Address - Phone:919-787-8883
Mailing Address - Fax:
Practice Address - Street 1:3700 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7154
Practice Address - Country:US
Practice Address - Phone:919-787-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08234OtherBCBS
NC2446299Medicare UPIN