Individual
DEBRA BALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1650 W OAK ST STE 110, ZIONSVILLE, IN 46077-3835
(317) 777-6400
(317) 777-6410
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003805A
IN
207Q00000X
Family Medicine Physician
OS013498
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019591580001
—
PA
05
—
201016980
—
IN
Enumeration date
05/12/2006
Last updated
11/24/2020
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