Provider Demographics
NPI:1023128840
Name:OPINALDO, PHILMA BALITE (MD)
Entity type:Individual
Prefix:MRS
First Name:PHILMA
Middle Name:BALITE
Last Name:OPINALDO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63638-0157
Mailing Address - Country:US
Mailing Address - Phone:573-663-2313
Mailing Address - Fax:573-663-2322
Practice Address - Street 1:225 PHYSICIANS PARKWAY
Practice Address - Street 2:SUITE 303
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901
Practice Address - Country:US
Practice Address - Phone:573-785-6536
Practice Address - Fax:573-785-0345
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2000153653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO131372OtherBLUE CROSS/BLUE SHIELD
MO205048408Medicaid
MO04-01168OtherUNITED HEALTH CARE
MO441968OtherHEALTHLINK
MO131372OtherBLUE CROSS/BLUE SHIELD
MOH19524Medicare UPIN