Provider Demographics
NPI:1801981998
Name:BALISH, DANIEL JONATHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JONATHAN
Last Name:BALISH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6903
Mailing Address - Country:US
Mailing Address - Phone:410-548-1644
Mailing Address - Fax:410-860-1155
Practice Address - Street 1:404 N FRUITLAND BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7261
Practice Address - Country:US
Practice Address - Phone:410-749-8401
Practice Address - Fax:410-860-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107081835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric