Provider Demographics
NPI:1467806711
Name:REGIONAL MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:REGIONAL MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-734-7246
Mailing Address - Street 1:240 BEISER BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8208
Mailing Address - Country:US
Mailing Address - Phone:302-734-7246
Mailing Address - Fax:
Practice Address - Street 1:240 BEISER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8208
Practice Address - Country:US
Practice Address - Phone:302-734-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2016602500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty