Individual
AGNES BALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, MAILSTOP 233MP1, BURLINGTON, VT 05401-1473
(802) 847-2700
Mailing address
111 COLCHESTER AVE, MAILSTOP 233MP1, BURLINGTON, VT 05401-1473
(802) 847-0392
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
042.0013986
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2014
Last updated
10/10/2018
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