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Contact Information

SAMUEL J BALLENTINE, MD
1290 SILAS DEANE HWY STE 101
WETHERSFIELD, CT06109-4337
 Phone: 860-859-9061
 Fax: 860-889-6200
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for SAMUEL J BALLENTINE · (Male)

NPI # 1881038735
Status Active
Credentials MD
Entity Individual
Enumeration date 04/22/2013
Last updated 12/29/2025 - About 5 months ago
Sole proprietor 1 No
Identifiers
  • MO License # 2019024601
  • MO Medicaid 200071078
Hospital affiliation(s)
  • BARNES JEWISH HOSPITAL - (Acute Care)
    ONE BARNES-JEWISH HOSPITAL PLAZA
    SAINT LOUIS, MO 63110
  • BARNES-JEWISH WEST COUNTY HOSPITAL - (Acute Care)
    12634 OLIVE BOULEVARD
    CREVE COEUR, MO 63141
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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