Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BALLARD GLENN BLAIR, D.P.M
Active Sole ProprietorBALLARD GLENN BLAIR, D.P.M is a Radiology Podiatrist healthcare provider located in SHELTON, Connecticut. NPI 1356350201 is currently active in the NPPES registry. Verify at CMS.
Radiology Podiatrist · SHELTON, CT
Registration Details
- NPI Number
- 1356350201
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 7, 2006 (19.830679713195 yrs)
- Last Updated
- Sep 4, 2013
- Licenses
-
00419 (CT)00419 (CT)00419 (CT)CT000419 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
375 BRIDGEPORT AVESHELTON, CT, 06484Browse CT providers · Browse ZIP 06484
- Phone
- 2039295559
- Fax
- 2039295277
- Primary Specialty
-
Radiology Podiatrist
213EP1101X
- Additional Specialty
- Radiology Podiatrist
- Additional Specialty
- Foot & Ankle Surgery Podiatrist
- Additional Specialty
- Podiatrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.