Provider Demographics
NPI:1467890723
Name:BALDWIN, BLAIR C (DO)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:C
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NORTH ST
Mailing Address - Street 2:APT 506
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5162
Mailing Address - Country:US
Mailing Address - Phone:339-225-5326
Mailing Address - Fax:
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:3 WARRINER
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-395-7916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255520208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery