Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 27722 | AZ |
N | 207RG0100X | Gastroenterologist | 27722 | AZ |
NPI | 1144204116 |
---|---|
Provider Name | Dr. Vijayan Balan |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 08/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E23680 | (02) |