Healthcare Provider Details

I. General information

NPI: 1528790490
Provider Name (Legal Business Name): IRINA BALAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 PROFESSIONAL PARK
ERWIN NC
28339-9106
US

IV. Provider business mailing address

215 BRIGHTWATER DR
LILLINGTON NC
27546-5156
US

V. Phone/Fax

Practice location:
  • Phone: 910-230-7930
  • Fax: 910-230-7949
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026-02596
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: