Individual
PRATAP BALUSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 W HIGH ST, STE 250, LIMA, OH 45801-3959
(419) 227-7399
(419) 229-0123
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-0001
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
72413
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024961
ANTHEM
—
05
—
2028291
—
OH
Enumeration date
08/30/2005
Last updated
10/31/2014
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