Individual
SHANNA MARIE P. BALTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2716 N TENAYA WAY, LAS VEGAS, NV 89128
(702) 877-8600
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
DO2304
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/18/2014
Last updated
06/26/2018
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