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Individual

ELANGOVAN BALAKRISHNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1705 E BROADWAY, SUITE 100, COLUMBIA, MO 65201-5852
(573) 874-7800
(573) 443-3627
Mailing address
1705 E BROADWAY STE 100, COLUMBIA, MO 65201-7167
(573) 874-7800
(573) 443-3627

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2004024397
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193438
BCBS OF MO
05
209024306
MO
01
5132415
AETNA
01
65201A011
TRICARE
01
689969
HEALTHLINK
Enumeration date
09/29/2005
Last updated
01/30/2025
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