Robert Ray Baltierra
Optometrist
44429 Ann Arbor Rd W
Plymouth
, Michigan 48170-3907
Robert Ray Baltierra
Optometrist
44429 Ann Arbor Rd W
Plymouth
, Michigan 48170-3907
(571) 223-6780
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Robert Ray Baltierra
- 1950 Old Gallows Rd Ste 520
- Vienna, VA
- Zip : 22182-3970
- Fax : (571) 223-6780
- Phone : (703) 847-8899
Second Address
- Robert Ray Baltierra
- 44429 Ann Arbor Rd W
- Plymouth, MI
- Zip : 48170-3907
- Phone : (734) 416-0348
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4901005154 | MI |
National Provider Identifier
| NPI | 1013442094 |
|---|---|
| Provider Name | Robert Ray Baltierra |
| First Address | Vienna, VA 22182-3970 |
| Second Address | Plymouth, MI 48170-3907 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/04/2017 |
| Last Update Date | 02/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0C97655 | BCBS (01) | MI |
| 1013442094 | (05) | MI |
| 1497781868 | (05) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.