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NPI Code Detail

MEDICARE: RAMADEVI BALIJA M.D.

MEDICARE: RAMADEVI BALIJA 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
1208000000XPediatrics Physician40733-020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881620292
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAMADEVI BALIJA M.D.
Provider Business Mailing Address
First Line : 5650 N GREEN BAY AVE
Second Line : SUITE 210
City : GLENDALE
State : WI
Zip : 53209-4446
Country : US
Telephone Number : 414-247-9530
Fax Number : 414-247-1875
Provider Business Practice Location Address
First Line : 5650 N GREEN BAY AVE
Second Line : SUITE 210
City : GLENDALE
State : WI
Zip : 53209-4446
Country : US
Telephone Number : 414-247-9530
Fax Number : 414-247-1875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 11/18/2014

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