Provider Demographics
NPI:1952415952
Name:BALDWIN, DREW EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:EDWARD
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:33501 1ST WAY S
Practice Address - Street 2:VIRGINIA MASON FEDERAL WAY CARDIOLOGY
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6208
Practice Address - Country:US
Practice Address - Phone:253-838-2400
Practice Address - Fax:253-874-1708
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60245440207RC0000X, 207RI0011X
LA202022207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1952415952Medicaid
MS04922804Medicaid
LA1163805Medicaid
WAMD00426OtherAK MEDICAID
WA8907871Medicare PIN
LA1163805Medicaid
WA1952415952Medicaid
WA8907872Medicare PIN