MEDICARE: DR. CHRISTOPHER O BALDWIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	2006005743	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	268653	OTHER	MO	MEDICARE OSCAR
4	P01604050	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26D2006074	OTHER	MO	CLIA
3	26D0889777	OTHER	MO	CLIA

General Provider Information

NPI Number	:	1164483921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER O BALDWIN M.D.

Provider Business Mailing Address
First Line	:	1337 S SAM HOUSTON BLVD
Second Line	:
City	:	HOUSTON
State	:	MO
Zip	:	65483-2046
Country	:	US
Telephone Number	:	417-967-5639
Fax Number	:	417-967-5667

Provider Business Practice Location Address
First Line	:	1337 S SAM HOUSTON BLVD
Second Line	:
City	:	HOUSTON
State	:	MO
Zip	:	65483
Country	:	US
Telephone Number	:	417-967-5639
Fax Number	:	417-967-5667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	07/22/2020

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Directions to “ DR. CHRISTOPHER O BALDWIN M.D.” Practice Location

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