Provider Demographics
NPI:1518922350
Name:BALTZER, ROBERT LEE JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:BALTZER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 HOSPICE CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6372
Mailing Address - Country:US
Mailing Address - Phone:919-828-0890
Mailing Address - Fax:919-719-0395
Practice Address - Street 1:250 HOSPICE CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6372
Practice Address - Country:US
Practice Address - Phone:919-828-0890
Practice Address - Fax:919-719-0395
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142368207R00000X
HI13461207R00000X
NC2024-01021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine