Healthcare Provider Details

I. General information

NPI: 1811374713
Provider Name (Legal Business Name): ASEEM SINGH BALHARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ASEEM SINGH BALHARA MD

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOUTHERN AVE SE
WASHINGTON DC
20032
US

IV. Provider business mailing address

1310 SOUTHERN AVE SE
WASHINGTON DC
20032-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-574-5323
  • Fax: 202-574-5225
Mailing address:
  • Phone: 202-574-5323
  • Fax: 202-574-5225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT208195
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD046578
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT208195
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: