1801883962 NPI number — STEVEN T BALDWIN MD

Table of content: STEVEN T BALDWIN MD (NPI 1801883962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801883962 NPI number — STEVEN T BALDWIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BALDWIN
Provider First Name:
STEVEN
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801883962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 55823
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35255-5823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-638-9587
Provider Business Mailing Address Fax Number:
205-975-4623

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 7TH AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233-1711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-939-9587
Provider Business Practice Location Address Fax Number:
205-975-4623
Provider Enumeration Date:
10/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD.11967 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0204X , with the licence number: MD.11967 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207P00000X , with the licence number: MD.11967 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009928410 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102674 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801883962 . This is a "TRICARE SOUTH" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 5086484 . This is a "AETNA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 510-95313 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 510-46000 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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