Provider Demographics
NPI:1487541959
Name:BALDWIN, DONOVAN RA'SHAWN
Entity type:Individual
Prefix:
First Name:DONOVAN
Middle Name:RA'SHAWN
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10842 HAMMETT PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-6046
Mailing Address - Country:US
Mailing Address - Phone:702-350-4820
Mailing Address - Fax:
Practice Address - Street 1:4530 S EASTERN AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6181
Practice Address - Country:US
Practice Address - Phone:702-545-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health