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DR. MATIAS BALLESTEROS MD

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1033672712

Individual Registrant:
DR. MATIAS  BALLESTEROS MD
Gender: M
Sole Proprietor

Location and contact information for practice:
1993 HARRISON ST  BATESVILLE, AR 72501-7309 US
Tel: 870-698-9992  Fax: --

Contact information for business:
9166 LANDON HOUSE LN  FREDERICK, MD 21704-7763 US
Tel: --  Fax: --

Registration Information:
NPI: 1033672712
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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