Organization
BALTES CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WM EDWARD BALTES MD (MANAGING PARTNER)
(260) 439-0044
Entity
Organization
Contact information
Practice address
821 BROADWAY, FORT WAYNE, IN 46802-2107
(260) 439-0044
(260) 422-7860
Mailing address
821 BROADWAY, FORT WAYNE, IN 46802-2107
(260) 439-0044
(260) 422-7860
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01026188A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090931
ANTHEM TPR
IN
01
—
000000090932
WEB ANTHEM
IN
05
—
100059740A
—
IN
05
—
100330950
—
IN
05
—
100460500
—
IN
01
—
295429889004
BCBS TPR
IN
01
—
303562034003
BCBS
IN
Enumeration date
09/02/2006
Last updated
06/30/2009
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