| Doctor Name: | DR. EDGAR HENRY BALLENAS |
| NPI Number: | 1023192291 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 71683 |
| Business Practice Address: | 275 Sandwich St Plymouth, MA - 023602183 |
| Business Phone Number: | 5088302800 |
| Business Fax Number: | |
| Mailing Address: | 198 Church St, MARSHFIELD |
| State: | MA |
| Postal Code: | 020501710 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NR1301X |
| License Number: | 71683 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Rural |
| Taxonomy Definition: | |