Provider Demographics
NPI:1346254976
Name:SCIOTO VALLEY UROLOGY INC
Entity Type:Organization
Organization Name:SCIOTO VALLEY UROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BALUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-222-3369
Mailing Address - Street 1:500 E MAIN ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5369
Mailing Address - Country:US
Mailing Address - Phone:614-222-3369
Mailing Address - Fax:614-224-1208
Practice Address - Street 1:500 E MAIN ST
Practice Address - Street 2:SUITE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5369
Practice Address - Country:US
Practice Address - Phone:614-222-3369
Practice Address - Fax:614-224-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9294683Medicare ID - Type Unspecified
OH9294684Medicare ID - Type Unspecified
OH9294681Medicare ID - Type Unspecified