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Organization
MICHAEL C BALOGA DPM, PC
Active
Organization
MICHAEL C BALOGA DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BALOGA, DPM,PC DPM, PC (OWNER DR)
(570) 654-4371
Entity
Organization
Contact information
Practice address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2768
(570) 654-4371
(570) 654-0455
Mailing address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2768
(570) 654-4371
(570) 654-0455
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003071L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003071L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028012370001
—
PA
Enumeration date
02/08/2008
Last updated
01/13/2014
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