Baltierra, Robert Ray

Baltierra, Robert Ray is an sole proprietor health care provider with primary practice located at 44429 Ann Arbor Rd W , Plymouth MI 48170-3907. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Baltierra, Robert Ray can be contacted via phone (734) 416-0348.

Contact Information

Primary practice address
44429 Ann Arbor Rd W Plymouth MI 48170-3907
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901005154 Michigan

Profile Details

NPI number 1013442094
LBN Legal business name Baltierra, Robert Ray
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2017
Last updated May 9th, 2024 - about 6 months ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013442094 NPPES
Michigan Other 0C97655 BCBS
Michigan MEDICAID 1013442094 BCBS
Michigan MEDICAID 1497781868 BCBS

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