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Individual

CYNTHIA ANN BALLENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
514 N BRIGHTLEAF BLVD STE 1200, SMITHFIELD, NC 27577-4486
(919) 209-3555
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0101 230080
VA
2085R0001X
Radiation Oncology Physician
051907
GA
2085R0001X
Radiation Oncology Physician
Primary
96-01555
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12773
BCBS
NC
05
1811095771
NC
01
205504
MEDCOST
NC
01
7331362
AETNA
NC
01
8373963
CIGNA
NC
05
8912773
NC
01
P00612671
RAILROAD MEDICARE
NC
01
P01619309
RR MEDICARE
NC
Enumeration date
09/21/2006
Last updated
03/23/2020
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