Basic Information
Provider Information
NPI: 1497948731
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALDWIN
FirstName: ELIZABETH
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 E 28TH ST
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554073723
CountryCode: US
TelephoneNumber: 6128631552
FaxNumber:  
Practice Location
Address1: 205 WABASHA ST S
Address2:  
City: SAINT PAUL
State: MN
PostalCode: 551071805
CountryCode: US
TelephoneNumber: 6512938100
FaxNumber: 6512938106
Other Information
ProviderEnumerationDate: 08/21/2007
LastUpdateDate: 11/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X53858MNN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VM0101X53858MNY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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