Provider Demographics
NPI:1043267651
Name:BALDWIN MD INC BENNER MD INC & BENNER MD INC GEN PTR
Entity type:Organization
Organization Name:BALDWIN MD INC BENNER MD INC & BENNER MD INC GEN PTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-293-2020
Mailing Address - Street 1:26625 CARMEL CENTER PL STE 100
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8689
Mailing Address - Country:US
Mailing Address - Phone:831-293-2020
Mailing Address - Fax:831-269-5293
Practice Address - Street 1:26625 CARMEL CENTER PL STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8689
Practice Address - Country:US
Practice Address - Phone:831-293-2020
Practice Address - Fax:831-269-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ34892ZMedicare PIN