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NPI Code Detail

MEDICARE: DR. CURTIS COULTER BALTZ MD

MEDICARE: DR. CURTIS COULTER BALTZ MD
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
1207R00000XInternal Medicine Physician19944WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110034806OTHERWIRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119944OTHERWVSTATE LICENSE
352D0671586OTHERWVCLIA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316939325
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CURTIS COULTER BALTZ MD
Provider Business Mailing Address
First Line : 122 E COLLEGE AVE
Second Line :
City : APPLETON
State : WI
Zip : 54911-5794
Country : US
Telephone Number : 920-996-3264
Fax Number : 920-830-5910
Provider Business Practice Location Address
First Line : 333 N GREEN BAY RD
Second Line :
City : NEENAH
State : WI
Zip : 54956-1954
Country : US
Telephone Number : 920-725-2070
Fax Number : 920-725-4549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 03/07/2023

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