Individual
MICHAEL BALISTRERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-6772
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-6772
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
56561
WI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
56561-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225353055
—
WI
Enumeration date
04/05/2010
Last updated
02/01/2024
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