Provider Demographics
NPI:1821271503
Name:CHARLES E. BALDWIN MD
Entity Type:Organization
Organization Name:CHARLES E. BALDWIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-481-3006
Mailing Address - Street 1:502 MADISON OAK
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4084
Mailing Address - Country:US
Mailing Address - Phone:210-481-3006
Mailing Address - Fax:210-481-3793
Practice Address - Street 1:18866 STONE OAK PKWY # 103-21
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4180
Practice Address - Country:US
Practice Address - Phone:210-481-3006
Practice Address - Fax:210-481-3793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM38842086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0030NXOtherBCBS