Provider Demographics
NPI:1932156304
Name:BALINT, TARA DOUGLAS (MD)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:DOUGLAS
Last Name:BALINT
Suffix:
Gender:F
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:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-689-5800
Mailing Address - Fax:757-431-7136
Practice Address - Street 1:2006 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-5800
Practice Address - Fax:757-431-7136
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012396802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1932156304Medicaid
VA3810005978OtherWV MEDICAID
VA4689789OtherCIGNA
VA755741OtherSOUTHERN HEALTH
VA345914OtherANTHEM
VA1000870001OtherDME PROVIDER