Provider Demographics
NPI:1437115391
Name:BALUH, THOMAS JOHN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOHN
Last Name:BALUH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 N. SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-267-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN221538L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120420418OtherDEPT OF LABOR
PA25-1716306OtherMULTIPLAN/PHCS
PAG920-0085/85XWCUOtherCAREFIRST
PAP00602488OtherRAILROAD MEDICARE
PA007390383Medicaid
PA258232OtherUNISON
PA050514OtherMEDICARE GROUP #
PA25-1716306OtherHEALTHNET/TRICARE
PA50075721OtherCAPITAL BLUECROSS
PARN221538LOtherRN LICENSE #
PA007390383Medicaid