Provider Demographics
NPI:1801829650
Name:JANET M BALBIERZ MD PC
Entity Type:Organization
Organization Name:JANET M BALBIERZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALBIERZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-743-6444
Mailing Address - Street 1:166 E 5900 S STE B106
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7350
Mailing Address - Country:US
Mailing Address - Phone:801-743-6444
Mailing Address - Fax:
Practice Address - Street 1:166 E 5900 S STE B106
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7350
Practice Address - Country:US
Practice Address - Phone:801-743-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT180261-1205208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000059468Medicare PIN