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Organization
NORTHWOODS FAMILY ORTHOPAEDICS S.C.
Active
Organization
NORTHWOODS FAMILY ORTHOPAEDICS S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S BALAS M.D. (PRESIDENT)
(715) 561-4795
Entity
Organization
Contact information
Practice address
502 COPPER ST, HURLEY, WI 54534-1345
(715) 561-4795
Mailing address
200 E WASHINGTON ST, P O BOX 8031, APPLETON, WI 54911-5490
(888) 833-8200
(920) 739-0124
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002700242
BLUE CROSS GROUP #
MI
05
—
32860600
—
WI
Enumeration date
06/02/2006
Last updated
06/30/2008
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