Healthcare Provider Details

I. General information

NPI: 1891723441
Provider Name (Legal Business Name): BALDWIN PHYSICIAN SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 HAND AVE
BAY MINETTE AL
36507-4110
US

IV. Provider business mailing address

PO BOX 830529
BIRMINGHAM AL
35283-0529
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM E ADMIRE
Title or Position: CEO & SEC/TRES
Credential: DO
Phone: 251-435-2646