Individual
BALASINGAM THEVAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4120 N 108TH AVE STE 116, PHOENIX, AZ 85037-5773
(623) 872-1818
Mailing address
8245 N 27TH AVE APT 204, PHOENIX, AZ 85051-6369
(916) 934-8724
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
R79125
AZ
Other
Enumeration date
04/02/2022
Last updated
02/22/2023
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