Provider Demographics
NPI:1700345535
Name:BALDWIN JEFFERSON, AVIONNA LAVETTE (MD)
Entity type:Individual
Prefix:
First Name:AVIONNA
Middle Name:LAVETTE
Last Name:BALDWIN JEFFERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AVIONNA
Other - Middle Name:LAVETTE
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1487 SOUTH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2932
Mailing Address - Country:US
Mailing Address - Phone:412-651-7149
Mailing Address - Fax:
Practice Address - Street 1:400 PARNASSUS AVE # A2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:866-817-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179028207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery