Provider Demographics
NPI:1831288224
Name:BALDRICH, EVE L (NP)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:L
Last Name:BALDRICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3568
Mailing Address - Country:US
Mailing Address - Phone:302-430-7600
Mailing Address - Fax:302-430-7601
Practice Address - Street 1:18 SOUTH DUPONT HWY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963
Practice Address - Country:US
Practice Address - Phone:302-430-7600
Practice Address - Fax:302-430-7601
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000719701Medicaid
Q19011Medicare UPIN
DE000719701Medicaid