Provider Demographics
NPI:1164630315
Name:BALDWIN, THOMAS ELMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ELMER
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44640 SHALLOW FORD CT
Mailing Address - Street 2:
Mailing Address - City:TALL TIMBERS
Mailing Address - State:MD
Mailing Address - Zip Code:20690-2001
Mailing Address - Country:US
Mailing Address - Phone:301-994-3227
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD
Practice Address - Street 2:SUITE 133
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7446
Practice Address - Country:US
Practice Address - Phone:410-321-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist