Provider Demographics
NPI:1174714695
Name:BALOCH, SAEED AASIM (MD)
Entity type:Individual
Prefix:
First Name:SAEED
Middle Name:AASIM
Last Name:BALOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 10TH AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3600
Mailing Address - Country:US
Mailing Address - Phone:706-257-4500
Mailing Address - Fax:706-257-4510
Practice Address - Street 1:1900 10TH AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3600
Practice Address - Country:US
Practice Address - Phone:706-257-4500
Practice Address - Fax:706-257-4510
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALMD 28256207R00000X
GA65214207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5101110101Medicare PIN
GA202I110431Medicare PIN