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NPI Code Detail

MEDICARE: DR. NAZRA BALUCH M.D.

MEDICARE:  DR. NAZRA  BALUCH  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician001563GA

General Provider Information

NPI Number : 1366628117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAZRA BALUCH M.D.
Provider Business Mailing Address
First Line : 1692 ATKINSON PARK CIR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-7937
Country : US
Telephone Number : 678-377-4698
Fax Number :
Provider Business Practice Location Address
First Line : 1692 ATKINSON PARK CIR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-7937
Country : US
Telephone Number : 678-377-4698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2008
Last Update Date : 01/10/2008

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Directions to “ DR. NAZRA BALUCH M.D.” Practice Location

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