Provider Demographics
NPI:1396787438
Name:BALDINO, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BALDINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:147 SUMMERS POINT DR
Mailing Address - Street 2:#135A-501
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-8527
Mailing Address - Country:US
Mailing Address - Phone:973-713-5739
Mailing Address - Fax:
Practice Address - Street 1:24 CREE DR
Practice Address - Street 2:STE A
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2639
Practice Address - Country:US
Practice Address - Phone:570-893-5191
Practice Address - Fax:570-893-5333
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD017458E208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
C33161Medicare UPIN
PA101672Medicare ID - Type Unspecified