Provider Demographics
NPI:1295708592
Name:BALOCH, MOHAMMAD H (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:H
Last Name:BALOCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:3100 DURALEIGH RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8104
Practice Address - Country:US
Practice Address - Phone:984-215-4570
Practice Address - Fax:984-215-4571
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC25688207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890158KMedicaid
NC890158KMedicaid
NC202395AMedicare PIN