Individual
GARY MATTHEW BALIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1254 N MAIN ST, LAPEER, MI 48446-1343
(810) 664-4531
(810) 667-7337
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301053578
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11426625
CAQH
MI
Enumeration date
08/20/2006
Last updated
08/09/2012
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