Provider Demographics
NPI:1164493268
Name:BALENTINE, JOHN RICH III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RICH
Last Name:BALENTINE
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:501 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3843
Mailing Address - Country:US
Mailing Address - Phone:757-547-5145
Mailing Address - Fax:757-312-0216
Practice Address - Street 1:150 BURNETTS WAY STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8168
Practice Address - Country:US
Practice Address - Phone:757-547-5145
Practice Address - Fax:757-539-7488
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2021-02-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant