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Individual

DR. ZACHARY E BALLENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 917-5000
Mailing address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 917-5000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01071787A
IN
2085R0202X
Diagnostic Radiology Physician
11016227A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
ME144863
FL
2085R0202X
Diagnostic Radiology Physician
Q4896
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201106150
IN
Enumeration date
08/15/2011
Last updated
10/21/2020
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