Individual
DR. CAROLYN OATES BALLANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
508 FULTON ST, DURHAM VAMC, MAIL CODE 116-A, DURHAM, NC 27705-3875
(919) 212-3011
(919) 255-1540
Mailing address
8804 WELLSLEY WAY, RALEIGH, NC 27613-1358
(919) 593-5548
(919) 929-8900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200201134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396X
BCBS NC
NC
Enumeration date
05/24/2006
Last updated
06/06/2008
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