Individual
SUDHA BALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1000
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
63925
AZ
207LP3000X
Pediatric Anesthesiology Physician
35083574
OH
207LP3000X
Pediatric Anesthesiology Physician
Primary
63925
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034
—
AZ
05
—
2729060
—
OH
Enumeration date
03/19/2007
Last updated
11/03/2023
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