Provider Demographics
NPI:1578773131
Name:BAL, NAVEET S (MD)
Entity Type:Individual
Prefix:
First Name:NAVEET
Middle Name:S
Last Name:BAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4805 S MOORLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7401
Mailing Address - Country:US
Mailing Address - Phone:862-290-0036
Mailing Address - Fax:414-259-1145
Practice Address - Street 1:4805 S MOORLAND RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7401
Practice Address - Country:US
Practice Address - Phone:862-290-0036
Practice Address - Fax:414-259-1145
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI53166207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1578773131Medicaid
WI1578773131Medicaid