Provider Demographics
NPI:1831190776
Name:PERMASHWAR, BALICHAND (MD)
Entity type:Individual
Prefix:
First Name:BALICHAND
Middle Name:
Last Name:PERMASHWAR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3011
Mailing Address - Country:US
Mailing Address - Phone:910-272-3051
Mailing Address - Fax:910-738-3764
Practice Address - Street 1:1638 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900991Medicaid
NC139TXOtherBCBS OF NC
NC139TXOtherBCBS OF NC
NCI33022Medicare UPIN
NC2041371Medicare ID - Type UnspecifiedJULIAN T PIERCE HLTH CTR
NC2041371BMedicare ID - Type UnspecifiedSOUTH ROBESON MEDICAL CTR
NC2041371CMedicare ID - Type UnspecifiedLUMBERTON HEALTH CENTER