Provider Demographics
NPI:1285702142
Name:BALDT, SHEILA ERIN (MSOM)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:ERIN
Last Name:BALDT
Suffix:
Gender:F
Credentials:MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 CRANSTON ST SUITE H
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-946-7734
Mailing Address - Fax:401-946-7734
Practice Address - Street 1:1681 CRANSTON ST SUITE H
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-946-7734
Practice Address - Fax:401-946-7734
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA000143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI263524OtherBCBS RI
RI0007287438OtherAETNA