Healthcare Provider Details

I. General information

NPI: 1548791106
Provider Name (Legal Business Name): STEVEN PAUL BALTIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 AKERS FARM ROAD SUITE C
CHRISTIANSBURG VA
24073
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 540-552-7133
  • Fax: 540-251-3516
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101281821
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2023-00893
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: