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General NPI Number Information
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NPI Number | 1104820554
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Entity Type | Individual
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Provider Name | CHARLES EUGENE BALDWIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 502 MADISON OAK DRIVE SUITE 330
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4298
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Country | US
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Telephone | 210-481-3006
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Fax | 210-481-3793
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Provider Business Mailing Address
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Address Line | 502 MADISON OAK DRIVE SUITE 330
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4298
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Country | US
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Telephone | 210-481-3006
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Fax | 210-481-3793
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 7025
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | M3884
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License Number State | TX
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