Provider Demographics
NPI:1023379153
Name:BALMORIA, SANDRA K (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:BALMORIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:BURRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20280 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417
Mailing Address - Country:US
Mailing Address - Phone:757-414-0400
Mailing Address - Fax:
Practice Address - Street 1:5219 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:NEW CHURCH
Practice Address - State:VA
Practice Address - Zip Code:23415-1715
Practice Address - Country:US
Practice Address - Phone:757-414-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116024489207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine