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Individual

DR. RICHARD J BALTARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 MOYE BLVD, GREENVILLE, NC 27834-4300
(252) 744-2803
(252) 744-3616
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3258

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2012-02097
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
21838
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1748E
BCBS
NC
05
5922177
NC
Enumeration date
08/18/2006
Last updated
04/29/2013
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