Provider Demographics
NPI:1326476672
Name:INFECTIOUS DISEASE SPECIALIST OF COLUMBUS, P.C.
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE SPECIALIST OF COLUMBUS, P.C.
Other - Org Name:SAEED BALOCH, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEED
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:706-257-4500
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA65214207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I110431Medicare PIN
AL5101110101Medicare PIN