Provider Demographics
NPI:1508026485
Name:ALAN BALSAM M D P A
Entity Type:Organization
Organization Name:ALAN BALSAM M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALSAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-350-3100
Mailing Address - Street 1:3275 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9536
Mailing Address - Country:US
Mailing Address - Phone:954-426-2898
Mailing Address - Fax:954-428-2769
Practice Address - Street 1:3275 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9536
Practice Address - Country:US
Practice Address - Phone:954-426-2898
Practice Address - Fax:954-428-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22243207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty