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NPI Code Detail

MEDICARE: STEVEN BALTES PHARMD

MEDICARE: STEVEN BALTES PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist119256MN

General Provider Information

NPI Number : 1225323363
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN BALTES PHARMD
Provider Business Mailing Address
First Line : 4848 COUNTY ROAD 101
Second Line : T-1356
City : MINNETONKA
State : MN
Zip : 55345-2635
Country : US
Telephone Number : 952-401-3814
Fax Number : 952-401-3814
Provider Business Practice Location Address
First Line : 4848 COUNTY ROAD 101
Second Line : T-1356
City : MINNETONKA
State : MN
Zip : 55345-2635
Country : US
Telephone Number : 952-401-3814
Fax Number : 952-401-3814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2011
Last Update Date : 06/16/2011

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