Provider Demographics
NPI:1790851483
Name:BALDWIN, JAMES G (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:689 ODIN ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-947-6800
Mailing Address - Fax:207-947-6872
Practice Address - Street 1:689 ODIN ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-947-6800
Practice Address - Fax:207-947-6872
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1740207Q00000X
MEDO1740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEH62287Medicare UPIN
MEMM9420Medicare ID - Type Unspecified