Healthcare Provider Details

I. General information

NPI: 1033769856
Provider Name (Legal Business Name): BALANCE MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 11/23/2023
Certification Date: 11/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 INTERCHANGE AVE STE 201
BISMARCK ND
58501-2084
US

IV. Provider business mailing address

1500 INTERCHANGE AVE
BISMARCK ND
58501-2084
US

V. Phone/Fax

Practice location:
  • Phone: 701-498-4111
  • Fax: 701-516-8147
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: RHONDA SCHAFER-MCLEAN
Title or Position: MD/OWNER
Credential: MD
Phone: 701-425-4116