Provider Demographics
NPI:1164483921
Name:BALDWIN, CHRISTOPHER O (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:O
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1337 S SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MO
Mailing Address - Zip Code:65483-2046
Mailing Address - Country:US
Mailing Address - Phone:417-967-5639
Mailing Address - Fax:417-967-5667
Practice Address - Street 1:1337 S SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MO
Practice Address - Zip Code:65483
Practice Address - Country:US
Practice Address - Phone:417-967-5639
Practice Address - Fax:417-967-5667
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006005743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26D2006074OtherCLIA
MO268653OtherMEDICARE OSCAR
MO26D0889777OtherCLIA
MOP01604050OtherRAILROAD MEDICARE
MO1164483921Medicaid
MO1710004486OtherRH MEDICAID GROUP NUMBER