| Ballantyne Medical Group | |
|
15825 John J Delaney Dr Suite 200 Charlotte NC 28277-3146 | |
| (704) 384-1925 | |
| (704) 384-1930 |
| Full Name | Ballantyne Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 15825 John J Delaney Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Patrick D Easterling (SR. VICE PRESIDENT) |
| Authorized Official Contact | 7043849103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ballantyne Medical Group 1900 Randolph Rd Suite 500 Charlotte NC 28207-1106 Ph: (704) 384-9103 | Ballantyne Medical Group 15825 John J Delaney Dr Suite 200 Charlotte NC 28277-3146 Ph: (704) 384-1925 |
| NPI Number | 1548223803 |
|---|---|
| Provider Enumeration Date | 04/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548223803 | NPI | - | NPPES |
| 89014VG | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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