Individual
DR. ALFRED BALDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Mailing address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11529
WV
207Q00000X
Family Medicine Physician
25469
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0447795
MEDICARE PIN FOR OCCU MED
WV
05
—
0649130
—
OH
01
—
080106073
MEDICARE-RR PROVIDER NUMBER
WV
05
—
1609986926
—
WV
05
—
64694342
—
KY
05
—
Q056788
—
TN
Enumeration date
08/30/2006
Last updated
04/14/2021
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