Organization
BALA FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRIRAM H BALASUBRAMANIAN M.D (OWNER)
(410) 569-1001
Entity
Organization
Contact information
Practice address
2021B EMMORTON RD, SUITE 210, BEL AIR, MD 21015-8980
(410) 569-1001
(410) 569-1569
Mailing address
2021B EMMORTON RD, SUITE 210, BEL AIR, MD 21015-8980
(410) 569-1001
(141) 056-9156
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D52279
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
793302900
—
MD
Enumeration date
11/14/2008
Last updated
06/01/2010
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