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NPI Code Detail

MEDICARE: DR. RAJINDER D BALASURIYA D.O.

MEDICARE: DR. RAJINDER D BALASURIYA 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
1207R00000XInternal Medicine Physician02008574AIN

General Provider Information

NPI Number : 1356710362
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAJINDER D BALASURIYA D.O.
Provider Business Mailing Address
First Line : 3150 WARRICK DR
Second Line :
City : BOONVILLE
State : IN
Zip : 47601-8602
Country : US
Telephone Number : 812-858-3355
Fax Number : 812-858-3350
Provider Business Practice Location Address
First Line : 3150 WARRICK DR
Second Line :
City : BOONVILLE
State : IN
Zip : 47601-8602
Country : US
Telephone Number : 812-858-3355
Fax Number : 812-858-3350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2015
Last Update Date : 05/28/2026

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