Provider Demographics
NPI:1528175213
Name:BALDWIN, ANDREW G (MSPT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:G
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:512 OLD CHARLESTON RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1781
Mailing Address - Country:US
Mailing Address - Phone:540-447-4612
Mailing Address - Fax:
Practice Address - Street 1:201 ROSSER AVE # B
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3540
Practice Address - Country:US
Practice Address - Phone:540-943-4510
Practice Address - Fax:540-943-2318
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA2305204321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305204321OtherLICENSE #