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General NPI Number Information
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NPI Number | 1881879294
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Entity Type | Organization
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Legal Business Name | BALA MEDICAL, INC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 2 BALA PLZ SUITE PL-08
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1501
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Country | US
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Telephone | 610-667-1115
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Fax | 610-667-8008
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Provider Business Mailing Address
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Address Line | 1055 CHERRY HILL RD
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City | PRINCETON
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State | NJ
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Zip | 08540-7723
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Country | US
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Telephone | 908-208-4715
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AKBAR KHAN
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Credential | MD
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Telephone | 908-208-4715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD067862L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD067863L
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License Number State | PA
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