Provider Demographics
NPI:1972559771
Name:BALDWIN, LYNN LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:LOUISE
Last Name:BALDWIN
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 1:577 W RED PINE CIR
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-8819
Mailing Address - Country:US
Mailing Address - Phone:262-432-0233
Mailing Address - Fax:
Practice Address - Street 1:300 E SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:WALES
Practice Address - State:WI
Practice Address - Zip Code:53183-9664
Practice Address - Country:US
Practice Address - Phone:262-968-5933
Practice Address - Fax:262-968-5933
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI439118Medicare UPIN