Provider Demographics
NPI:1548791106
Name:BALTIC, STEVEN PAUL (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:BALTIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 AKERS FARM ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-552-7133
Practice Address - Fax:540-251-3516
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101281821207X00000X
NC2023-00893207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery