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NPI Code Detail

MEDICARE: DENISE HILLARD BALON MD

MEDICARE: DENISE HILLARD BALON MD
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 Physician4301043800MI

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 : 1861494965
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE HILLARD BALON MD
Provider Business Mailing Address
First Line : 15990 WEST NINE MILE ROAD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-2527
Country : US
Telephone Number : 248-849-4226
Fax Number : 248-849-4240
Provider Business Practice Location Address
First Line : 210 N LAFAYETTE ST
Second Line :
City : SOUTH LYON
State : MI
Zip : 48178-2048
Country : US
Telephone Number : 248-437-1744
Fax Number : 248-437-3245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 02/25/2011

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