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Individual

JAMES D BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
(765) 448-8684
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01055879A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000219002
ANTHEM PROVIDER NUMBER
IN
01
11319861
CAQH NUMBER
IN
01
170442
PHCS PID NUMBER
IN
05
200370170
IN
Enumeration date
03/14/2006
Last updated
01/23/2008
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