Provider Demographics
NPI:1659361053
Name:BALKANY, CHRISTOPHER KIM (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KIM
Last Name:BALKANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 13TH ST S.
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301
Mailing Address - Country:US
Mailing Address - Phone:320-259-4449
Mailing Address - Fax:
Practice Address - Street 1:2008 13TH ST S.
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301
Practice Address - Country:US
Practice Address - Phone:320-259-4449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN37289207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
1004431OtherPREFERRED ONE
3300076OtherMEDICA HEALTH PLANS
110104505OtherRR MEDICARE
217022100OtherMEDICAL ASSISTANCE MA
110892OtherU CARE
2114026OtherFIRST HEALTH PLAN
HP25402OtherHEALTH PARTNERS
596180OtherARAZ GROUP AMERICAS PPO
501R1BAOtherBLUE CROSS BLUE SHIELD
6D056BAOtherBLUE CROSS BLUE SHIELD
501R1BAOtherBLUE CROSS BLUE SHIELD
HP25402OtherHEALTH PARTNERS