Provider Demographics
NPI:1528044989
Name:BAL, SURJIT K (MD)
Entity Type:Individual
Prefix:DR
First Name:SURJIT
Middle Name:K
Last Name:BAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:561-712-7335
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:500 GYPSY LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1315
Practice Address - Country:US
Practice Address - Phone:330-884-3767
Practice Address - Fax:330-884-3790
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-03-6033-B207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F09354Medicare UPIN