Individual
DR. MICHAEL DAVID BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10 WILDWOOD MEDICAL CTR, ESSEX, CT 06426-1154
(860) 767-0145
Mailing address
10 WILDWOOD MEDICAL CTR, ESSEX, CT 06426-1154
(860) 767-0145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000490
CT
207QA0505X
Adult Medicine Physician
000490
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004902
—
CT
Enumeration date
03/17/2006
Last updated
05/30/2012
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