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
Phone: (734) 416-0348
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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 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 | 1013442094 | NPPES |
| Michigan | Other | 0C97655 | BCBS |
| Michigan | MEDICAID | 1013442094 | BCBS |
| Michigan | MEDICAID | 1497781868 | BCBS |
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