Healthcare Provider Details

I. General information

NPI: 1861492415
Provider Name (Legal Business Name): ARTHUR KIRSNER BALIN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CHESLEY DR
MEDIA PA
19063-1755
US

IV. Provider business mailing address

110 CHESLEY DR
MEDIA PA
19063-1755
US

V. Phone/Fax

Practice location:
  • Phone: 610-565-3300
  • Fax: 610-565-9909
Mailing address:
  • Phone: 610-565-3300
  • Fax: 610-565-9909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1462051
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number020728
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD019908E
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberH6769
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD019908E
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD019908E
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD0064913
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberC1-0008066
License Number StateDE
# 9
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberPAK000066
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License Number001240
License Number StatePA
# 11
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number09421500
License Number StatePA
# 12
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD019908E
License Number StatePA
# 13
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberMD019908E
License Number StatePA
# 14
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number09421500
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: