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Individual

CHRISTIAN BALLAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2158 INTELLIPLEX DR, SUITE 200, SHELBYVILLE, IN 46176-8846
(317) 392-3651
(317) 398-0538
Mailing address
1626 E STATE ROAD 44, STE A, SHELBYVILLE, IN 46176-4057
(317) 421-2012
(317) 398-1852

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01038703A
IN
208000000X
Pediatrics Physician
01038703A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100317710
IN
Enumeration date
06/01/2006
Last updated
11/23/2016
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