Individual
RAYMOND R BALLECER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3289 N MAYFAIR RD, WAUWATOSA, WI 53222-3203
(414) 771-7900
(414) 607-6336
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31513
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31626200
—
WI
01
—
P01142233
RR-MEDICARE
WI
Enumeration date
01/05/2007
Last updated
11/22/2021
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