Individual
KENNETH A. BALLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 RAY C HUNT DR, SUITE 2100, CHARLOTTESVILLE, VA 22903
(434) 924-2472
(434) 244-9442
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101047715
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006074171
—
VA
Enumeration date
12/19/2006
Last updated
08/08/2023
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