Provider Demographics
NPI:1164627766
Name:BALDA, LAURA MEGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MEGAN
Last Name:BALDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 N OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3512
Mailing Address - Country:US
Mailing Address - Phone:561-557-1767
Mailing Address - Fax:561-327-5125
Practice Address - Street 1:1000 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3512
Practice Address - Country:US
Practice Address - Phone:561-557-1767
Practice Address - Fax:561-327-5125
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine