Individual
JERRY J BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
(701) 234-7378
Mailing address
PO BOX 2010, FARGO, ND 58122-0605
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
20845
MN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
8476
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12418
—
ND
Enumeration date
07/18/2006
Last updated
12/29/2011
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