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MARK T BALLSHMIEDER — OIG Excluded Provider (MOSINEE, WI, 1128a1)

MARK T BALLSHMIEDER — OIG Excluded Provider (MOSINEE, WI, 1128a1) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: MARK T BALLSHMIEDER; Type: Individual; Provider category: PHARMACY.

NameMARK T BALLSHMIEDER
TypeIndividual
Provider categoryPHARMACY
SpecialtyPHARMACIST
CityMOSINEE
StateWI
ZIP54455
Exclusion authority1128a1
Exclusion reasonConviction of program-related crimes
Exclusion date1988-05-24
SourceHHS-OIG LEIE

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