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General NPI Number Information
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NPI Number | 1417816430
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Entity Type | Individual
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Provider Name | MARCUS BALLARD
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Gender | Male
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 273 NEW CREEK HWY
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City | KEYSER
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State | WV
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Zip | 26726-8216
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Country | US
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Telephone | 304-788-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 124 PIERCE ARROW WAY
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City | MARTINSBURG
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State | WV
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Zip | 25401-4402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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