MEDICARE: ARVIND J BALI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	27746	SC

General Provider Information

NPI Number	:	1053340935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARVIND J BALI M.D.

Provider Business Mailing Address
First Line	:	701 MEDICAL PARK DR
Second Line	:	SUITE 208
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-4777
Country	:	US
Telephone Number	:	843-383-5191
Fax Number	:	843-383-0115

Provider Business Practice Location Address
First Line	:	701 MEDICAL PARK DR
Second Line	:	SUITE 208
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-4777
Country	:	US
Telephone Number	:	843-383-5191
Fax Number	:	843-383-0115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	01/20/2011

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