Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 048066 | OH |
NPI | 1013034909 |
---|---|
Provider Name | Dr. Robert John Balchick |
First Address | New Albany, OH 43054-9680 |
Second Address | New Albany, OH 43054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 10/09/2012 |