Basic Information
| Provider Information | |||||||||
| NPI: | 1518920610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALDWIN | ||||||||
| FirstName: | BOYCE | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1856 | ||||||||
| Address2: | |||||||||
| City: | PAWLEYS ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295851856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8432373378 | ||||||||
| FaxNumber: | 8432375073 | ||||||||
| Practice Location | |||||||||
| Address1: | 509 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8432373378 | ||||||||
| FaxNumber: | 8432375073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 12/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 33342 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 12865 | 01 | NC | BCBS | OTHER | 930042430 | 01 | NC | RAILROAD | OTHER | NCR718A194 | 01 | NC | MEDICARE PTAN | OTHER | Q33342 | 01 | MDSC | OTHER | NCR718B | 01 | NC | MEDICARE PTAN | OTHER | 8912865 | 05 | NC | MEDICAID |