Healthcare Provider Details

I. General information

NPI: 1649206582
Provider Name (Legal Business Name): EDUARDO BALCELLS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 N JUSTICE ST STE A
HENDERSONVILLE NC
28791-3455
US

IV. Provider business mailing address

800 N JUSTICE ST # 16
HENDERSONVILLE NC
28791-3410
US

V. Phone/Fax

Practice location:
  • Phone: 828-697-7377
  • Fax: 828-697-7380
Mailing address:
  • Phone: 828-697-7377
  • Fax: 828-697-7380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number231106
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number36374
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number231106
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101055712
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number231106
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number36374
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101055712
License Number StateVA
# 8
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number2016-01203
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: