Provider Demographics
NPI:1235426453
Name:DR BALA AND ASSOCIATES A MAJOR HEALTH PARTNER LLC
Entity Type:Organization
Organization Name:DR BALA AND ASSOCIATES A MAJOR HEALTH PARTNER LLC
Other - Org Name:DR BALA AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PFS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-421-2012
Mailing Address - Street 1:1626 E STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-4026
Mailing Address - Country:US
Mailing Address - Phone:317-421-2012
Mailing Address - Fax:317-398-1852
Practice Address - Street 1:2158 INTELLIPLEX DR
Practice Address - Street 2:SUITE 106
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8548
Practice Address - Country:US
Practice Address - Phone:317-421-2012
Practice Address - Fax:317-398-1852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty