Provider Demographics
NPI:1780750885
Name:BALDWIN, JEREMY WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:WARREN
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:11848 ROCK LANDING DR STE 401
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4425
Practice Address - Country:US
Practice Address - Phone:757-243-8550
Practice Address - Fax:757-243-8552
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2021-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101242922207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine