Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 19276 | DC |
N | 2084N0600X | Clinical Neurophysiologist | 19276 | DC |
NPI | 1427140391 |
---|---|
Provider Name | Dr. Marshall Samuel Balish |
First Address | Rockville, MD 20852-4343 |
Second Address | Washington, DC 20422-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 23/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0452770 | (05) | DC |
77472 | (05) | MD |
F01480 | (02) | DC |