Provider Demographics
NPI:1841234945
Name:BALFOUR, HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:BALFOUR
Suffix:JR
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:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 437
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-0622
Mailing Address - Fax:612-626-2696
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:420 DELAWARE STREET SE, ROOM 760 MAYO MEMORIAL BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-0622
Practice Address - Fax:612-626-2696
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19585208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2T200BAOtherBCBS
MN1008859OtherPREFERRED ONE
MN100994OtherUCARE
MN11-74556OtherMEDICA PRIMARY
IA1990366Medicaid
MN11-24521OtherMEDICA CHOICE
MNHP22275OtherHEALTHPARTNERS
MN24478OtherARAZ
MN1008859OtherPREFERRED ONE