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Individual

EUGENE S BALKOVEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
15003 TURNEY RD, MAPLE HEIGHTS, OH 44137-4730
(216) 640-9525
Mailing address
PO BOX 670629, NORTHFIELD, OH 44067-0629
(216) 640-9525

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34001954
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000136584
ANTHEM
OH
05
0171648
OH
01
791011214
RAILROAD MEDICARE
01
T01954
SUMMA
OH
Enumeration date
10/03/2006
Last updated
07/30/2013
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