MEDICARE: DR. STEVEN LEE BALLAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35047548	OH
2	207RC0000X	Cardiovascular Disease Physician	MD043738L	PA
3	207R00000X	Internal Medicine Physician	35047548	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	H162972	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326039447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN LEE BALLAS MD

Provider Business Mailing Address
First Line	:	627 EASTLAND AVE SE
Second Line	:	STE 301
City	:	WARREN
State	:	OH
Zip	:	44484-4501
Country	:	US
Telephone Number	:	330-392-3099
Fax Number	:	330-395-1721

Provider Business Practice Location Address
First Line	:	627 EASTLAND AVE SE
Second Line	:	STE 301
City	:	WARREN
State	:	OH
Zip	:	44484-4501
Country	:	US
Telephone Number	:	330-392-3099
Fax Number	:	330-395-1721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/11/2016

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Directions to “ DR. STEVEN LEE BALLAS MD” Practice Location

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