Individual
JEREMIAH JOHN BALDWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
5303 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9013
(228) 822-5790
Mailing address
117 YUCCA DR, LONG BEACH, MS 39560-3904
(360) 969-1720
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/02/2012
Last updated
06/10/2012
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