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General NPI Number Information
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NPI Number | 1700099710
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Entity Type | Individual
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Provider Name | SANJEEVE BALASUBRAMANIAM MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 9000 ROCKVILLE PIKE BUILDING 10, ROOM 12N226, NIH
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-496-4916
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Fax |
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Provider Business Mailing Address
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Address Line | ROOM 12N226 BLDG 10 NATIONAL CANCER INSTITUTE, NIH
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-496-4916
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD034495
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License Number State | DC
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