Provider Demographics
NPI:1689822280
Name:BALDWIN, WILLIAM DAN
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAN
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 N 51ST PL
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5144
Mailing Address - Country:US
Mailing Address - Phone:602-404-0767
Mailing Address - Fax:602-404-0767
Practice Address - Street 1:6004 N 51ST PL
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-5144
Practice Address - Country:US
Practice Address - Phone:602-404-0767
Practice Address - Fax:602-404-0767
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies