MEDICARE: DR. ALAN K. BALICK 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
1	207R00000X	Internal Medicine Physician	MD047224L	PA

General Provider Information

NPI Number	:	1710229760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN K. BALICK M.D.

Provider Business Mailing Address
First Line	:	1421 ROYAL OAK DR
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-2165
Country	:	US
Telephone Number	:	484-653-8809
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 ROYAL OAK DR
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-2165
Country	:	US
Telephone Number	:	484-653-8809
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2013
Last Update Date	:	03/17/2013

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