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General NPI Number Information
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NPI Number | 1124195219
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Entity Type | Organization
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Legal Business Name | ROGER BALOGH
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 2951 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-1406
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Country | US
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Telephone | 740-454-0366
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Fax | 740-454-3790
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Provider Business Mailing Address
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Address Line | PO BOX 790
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City | ZANESVILLE
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State | OH
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Zip | 43702-0790
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Country | US
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Telephone | 740-454-0366
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Fax | 740-454-3790
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Authorized Official
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Title or Position | OWNER PROVIDER
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Name | ROGER JOHN BALOGH
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Credential | MD
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Telephone | 740-454-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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