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General NPI Number Information
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NPI Number | 1255429239
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Entity Type | Individual
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Provider Name | MEENA E BALA MD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9501 LUCY CORR CIR
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6697
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Country | US
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Telephone | 804-796-7089
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Fax |
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Provider Business Mailing Address
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Address Line | 9641 EGRET LN
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City | CHESTERFIELD
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State | VA
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Zip | 23838-8949
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Country | US
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Telephone | 804-748-9038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101036474
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License Number State | VA
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