Healthcare Provider Details

I. General information

NPI: 1699792101
Provider Name (Legal Business Name): OSCAR F BALLESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 HAL GREER BLVD
HUNTINGTON WV
25701-4114
US

IV. Provider business mailing address

1400 HAL GREER BLVD
HUNTINGTON WV
25701-4114
US

V. Phone/Fax

Practice location:
  • Phone: 304-399-6609
  • Fax: 304-399-6621
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number22706
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: