Provider Demographics
NPI:1326080763
Name:BALDT, CHRISTOPHER WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WILLIAM
Last Name:BALDT
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 1:98 RUDDER ROAD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966
Mailing Address - Country:US
Mailing Address - Phone:302-945-4575
Mailing Address - Fax:302-945-1910
Practice Address - Street 1:98 RUDDER ROAD
Practice Address - Street 2:UNIT 1
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-945-4575
Practice Address - Fax:302-945-1910
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000249111N00000X
NYXX0111741111N00000X
HI1071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T84940Medicare UPIN
BA557470Medicare ID - Type Unspecified