Provider Demographics
NPI:1568496859
Name:BALTEZEGAR, HELEN JEANETTE (CFM)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:JEANETTE
Last Name:BALTEZEGAR
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1616 SHIPYARD BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6561
Mailing Address - Country:US
Mailing Address - Phone:910-798-3834
Mailing Address - Fax:910-798-3834
Practice Address - Street 1:1616 SHIPYARD BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6561
Practice Address - Country:US
Practice Address - Phone:910-798-3834
Practice Address - Fax:910-798-3834
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5438140001Medicare NSC