MEDICARE: DR. GARY 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	016261	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AB32999	OTHER	WA	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7469BA	OTHER	WA	ASURIS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265404776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY BALDWIN M.D.

Provider Business Mailing Address
First Line	:	910 N WASHINGTON ST
Second Line	:	STE 209
City	:	SPOKANE
State	:	WA
Zip	:	99201-2202
Country	:	US
Telephone Number	:	509-232-1145
Fax Number	:	509-232-1165

Provider Business Practice Location Address
First Line	:	982 E COLUMBIA AVE
Second Line	:
City	:	COLVILLE
State	:	WA
Zip	:	99114-3316
Country	:	US
Telephone Number	:	509-935-0824
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	12/04/2007

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