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General NPI Number Information
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NPI Number | 1548419419
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Entity Type | Individual
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Provider Name | KIYANDA NYREE BALDWIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 125 HOSPITAL CENTER BLVD STE 201
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City | STAFFORD
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State | VA
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Zip | 22554-6203
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Country | US
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Telephone | 540-374-3212
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Fax | 540-374-3224
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Provider Business Mailing Address
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Address Line | 2300 FALL HILL AVE STE 509
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3343
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Country | US
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Telephone | 540-741-2277
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Fax | 540-741-1029
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 0101252582
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101252582
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License Number State | VA
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