Provider Demographics
NPI:1841286523
Name:BALLINGER, STEVEN G (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:BALLINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:832 ELM ST SW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2062
Mailing Address - Country:US
Mailing Address - Phone:541-812-5820
Mailing Address - Fax:541-812-5821
Practice Address - Street 1:832 ELM ST SW
Practice Address - Street 2:SUITE 101
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2062
Practice Address - Country:US
Practice Address - Phone:541-812-5820
Practice Address - Fax:541-812-5821
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD151185207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR211505Medicaid
ORR154746Medicare UPIN