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General NPI Number Information
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NPI Number | 1902990443
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Entity Type | Individual
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Provider Name | FREDERICK L BALLET MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 5000 SAGEMORE DRIVE SUITE 103
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-983-4263
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Fax | 856-983-9362
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Provider Business Mailing Address
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Address Line | 7000 ATRIUM WAY SUITE 6
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054
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Country | US
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Telephone | 856-206-4500
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Fax | 856-234-4241
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA41767
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | MA41767
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License Number State | NJ
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