Provider Demographics
NPI:1710229760
Name:BALICK, ALAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:K
Last Name:BALICK
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 1:1421 ROYAL OAK DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2165
Mailing Address - Country:US
Mailing Address - Phone:484-653-8809
Mailing Address - Fax:
Practice Address - Street 1:1421 ROYAL OAK DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2165
Practice Address - Country:US
Practice Address - Phone:484-653-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047224L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine