Balderston, Keith Douglas
Balderston, Keith Douglas is an individual health care provider with primary practice located at 3355 Riverbend Dr Ste 210, Springfield OR 97477-8800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine, which is considered as his primary health care specialty. Balderston, Keith Douglas can be contacted via phone (541) 485-2777.Contact Information
Primary practice address
3355 Riverbend Dr Ste 210
Springfield OR 97477-8800
Phone: (541) 485-2777
Fax: (541) 246-2353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine | 207VM0101X | MD18230 | Oregon |
| Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine | 207VM0101X | M-13818 | Idaho |
| Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine | 207VM0101X | MD60748459 | Washington |
Profile Details
| NPI number | 1871525337 |
|---|---|
| LBN Legal business name | Balderston, Keith Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | May 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871525337 | NPPES |
| Oregon | MEDICAID | 067731 |
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