Organization
BALLANTYNE MEDICAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ROBERT BAUER (PRESIDENT)
(704) 540-1640
Entity
Organization
Contact information
Practice address
12311 COPPER WAY, SUITE 100, CHARLOTTE, NC 28277-3386
(704) 540-1640
(704) 540-1639
Mailing address
12311 COPPER WAY, SUITE 100, CHARLOTTE, NC 28277-3386
(704) 540-1640
(704) 540-1639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006-01723
NC
Other
Enumeration date
01/18/2007
Last updated
08/18/2011
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