Provider Demographics
NPI:1790914372
Name:BALDASARE, MARIA DEL CARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:BALDASARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 MEDICAL CENTER PKWY STE 240B
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3204
Mailing Address - Country:US
Mailing Address - Phone:479-553-2200
Mailing Address - Fax:
Practice Address - Street 1:2900 MEDICAL CENTER PKWY STE 240B
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3204
Practice Address - Country:US
Practice Address - Phone:479-553-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-05
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195783207R00000X
ARE-12806207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine