Healthcare Provider Details

I. General information

NPI: 1508904699
Provider Name (Legal Business Name): DB INTERNAL & SPORTS MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MAIN ST STE 267
FREEHOLD NJ
07728-2537
US

IV. Provider business mailing address

901 W MAIN ST STE 267
FREEHOLD NJ
07728-2537
US

V. Phone/Fax

Practice location:
  • Phone: 732-677-3733
  • Fax: 732-677-3734
Mailing address:
  • Phone: 732-677-3733
  • Fax: 732-677-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DHIMANT JITENDRA BALAR
Title or Position: PRESIDENT
Credential: D.O.
Phone: 732-677-3733