Individual
ANNA ELISE BALLENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HOSPITAL DR # DC043.00, COLUMBIA, MO 65212-3748
(573) 882-1767
Mailing address
1 HOSPITAL DR # DC043.00, COLUMBIA, MO 65212-3748
(573) 882-1767
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2024024315
MO
207R00000X
Internal Medicine Physician
2023019866
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2022
Last updated
06/26/2024
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