Individual
ANDREW BALAVITCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 551-5000
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1867
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704297101
MI
Other
Enumeration date
07/01/2016
Last updated
12/15/2020
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