Individual
MARIANNE MULLIN BALLISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
534 BILTMORE AVE, ASHEVILLE, NC 28801-4612
(828) 213-0801
Mailing address
PO BOX 1987, INDIANAPOLIS, IN 46206-1987
(828) 253-3322
(828) 253-1895
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2012-01127
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920731
—
NC
01
—
P01090765
RR MEDICARE
NC
Enumeration date
01/29/2008
Last updated
02/13/2014
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