Individual
CHARLOTTE BALLANTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER, ALBUQUERQUE, NM 87131-9654
(720) 692-6068
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
207R00000X
Internal Medicine Physician
DO2023-1011
NM
208M00000X
Hospitalist Physician
Primary
DO2023-1011
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
03/22/2010
Last updated
08/07/2025
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