Individual
MR. GREGORY BRUCE BALLENGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 HOLLAND ST, ERIE, PA 16507
(814) 453-5058
Mailing address
5804 WIND CHIME LANE, FAIRVIEW, PA 16415
(814) 835-1756
(814) 452-4174
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD056573L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1537370
—
PA
Enumeration date
09/26/2006
Last updated
07/08/2007
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