Individual
MITCHELL I BALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 953-9600
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35084929
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2538936
—
OH
Enumeration date
06/07/2006
Last updated
01/08/2021
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