Organization
DANA BALDERRAMA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA S BALDERRAMA MD (OWNER)
(928) 453-9487
Entity
Organization
Contact information
Practice address
1945 MESQUITE AVE STE D, LAKE HAVASU CITY, AZ 86403-5889
(928) 453-9487
(928) 453-9562
Mailing address
1945 MESQUITE AVE STE D, LAKE HAVASU CITY, AZ 86403-5889
(928) 453-9487
(928) 453-9562
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
Other
Enumeration date
08/11/2006
Last updated
11/08/2007
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