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General NPI Number Information
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NPI Number | 1861542565
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Entity Type | Individual
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Provider Name | OFELIA BALAGTAS-BALMASEDA M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 4812 S 7TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4502
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Country | US
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Telephone | 812-299-7422
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Fax | 812-299-1683
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Provider Business Mailing Address
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Address Line | 830 E GILCHRIST DR
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4740
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Country | US
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Telephone | 812-299-7422
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Fax | 812-299-1683
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 10037984
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License Number State | IN
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