Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 51067 | KY |
NPI | 1033406277 |
---|---|
Provider Name | Dr. Gregory Balabanian |
First Address | Hazard, KY 41701-9466 |
Second Address | Hazard, KY 41701-9466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2011 |
Last Update Date | 16/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100528170 | (05) | KY |