Provider Demographics
NPI:1699067272
Name:BALDIT, CARLOS ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANTONIO
Last Name:BALDIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5707
Mailing Address - Country:US
Mailing Address - Phone:602-322-1315
Mailing Address - Fax:602-322-1316
Practice Address - Street 1:1311 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5707
Practice Address - Country:US
Practice Address - Phone:602-322-1315
Practice Address - Fax:602-322-1316
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44502208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics