Basic Information
Provider Information
NPI: 1982852281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALDWIN
FirstName: GREGORY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 9TH AVE
Address2: MS:M4-PFS
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2065155811
FaxNumber:  
Practice Location
Address1: 1100 9TH AVE
Address2: MS:B2-AN
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2062236980
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2008
LastUpdateDate: 04/04/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X49403CON Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XMD 60201288WAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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