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NPI Code Detail

MEDICARE: DR. NORMAN M BALOG D.O.

MEDICARE:  DR. NORMAN M BALOG  D.O.
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
1207Q00000XFamily Medicine PhysicianH0048219MD

General Provider Information

NPI Number : 1285624577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NORMAN M BALOG D.O.
Provider Business Mailing Address
First Line : 15504 WILLISTON RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20905-4243
Country : US
Telephone Number : 301-879-0179
Fax Number :
Provider Business Practice Location Address
First Line : 15504 WILLISTON RD
Second Line : DOC AT YOUR DOOR, LLC
City : SILVER SPRING
State : MD
Zip : 20905-4243
Country : US
Telephone Number : 301-879-0179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 10/19/2010

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Directions to “ DR. NORMAN M BALOG D.O.” Practice Location

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