Healthcare Provider Details
I. General information
NPI: 1689772576
Provider Name (Legal Business Name): REGIONAL MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
240 BEISER BLVD SUITE 201A
DOVER DE
19904-8208
US
IV. Provider business mailing address
240 BEISER BLVD SUITE 201A
DOVER DE
19904-8208
US
V. Phone/Fax
- Phone: 302-734-7246
- Fax:
- Phone: 302-734-7246
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GANESH
R
BALU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-312-3809