Provider Demographics
NPI:1568519858
Name:CHRISTOPHER O BALDWIN, MD LLC
Entity Type:Organization
Organization Name:CHRISTOPHER O BALDWIN, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:O
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-341-0139
Mailing Address - Street 1:1050 W 10TH STREET
Mailing Address - Street 2:SUITE 530
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401
Mailing Address - Country:US
Mailing Address - Phone:573-341-0139
Mailing Address - Fax:573-341-0142
Practice Address - Street 1:1050 W 10TH STREET
Practice Address - Street 2:SUITE 530
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401
Practice Address - Country:US
Practice Address - Phone:573-341-0139
Practice Address - Fax:573-341-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty