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NPI Code Detail

MEDICARE: DR. RAJ BALLAL M.D.

MEDICARE:  DR. RAJ  BALLAL  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
1207RC0000XCardiovascular Disease PhysicianMA65996NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386645638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAJ BALLAL M.D.
Provider Business Mailing Address
First Line : 622 GEORGES RD
Second Line : SUITE 303
City : NORTH BRUNSWICK
State : NJ
Zip : 08902-3377
Country : US
Telephone Number : 732-745-4994
Fax Number : 732-745-7044
Provider Business Practice Location Address
First Line : 98 JAMES ST
Second Line : SUITE 300
City : EDISON
State : NJ
Zip : 08820-3902
Country : US
Telephone Number : 732-548-2523
Fax Number : 732-549-8827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 01/14/2010

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Directions to “ DR. RAJ BALLAL M.D.” Practice Location

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