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Individual

MARK D. BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
819 SOUTH 13TH STREET, MOUNT VERNON, WA 98273
(360) 814-6230
(360) 814-6240
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP60600878
WA
207RN0300X
Nephrology Physician
34-00-5880-B
OH
207RN0300X
Nephrology Physician
OP60600878
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0059120
OH
05
0947195
OH
Enumeration date
09/06/2006
Last updated
01/04/2016
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