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General NPI Number Information
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NPI Number | 1790914372
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Entity Type | Individual
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Provider Name | MARIA DEL CARMEN BALDASARE M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2009
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 2900 MEDICAL CENTER PKWY STE 240B
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City | BENTONVILLE
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State | AR
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Zip | 72712-3204
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Country | US
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Telephone | 479-553-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 MEDICAL CENTER PKWY STE 240B
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City | BENTONVILLE
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State | AR
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Zip | 72712-3204
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Country | US
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Telephone | 479-553-2200
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT195783
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | E-12806
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License Number State | AR
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