Individual
DR. EDWARD S BALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 W SILVER ST, WESTFIELD, MA 01085-3628
(413) 568-2811
(413) 572-5192
Mailing address
115 W SILVER ST, WESTFIELD, MA 01085-3628
(413) 568-2811
(413) 572-5192
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
76517
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076517
TUFTS
MA
01
—
10418
HEALTH NEW ENGLAND
MA
05
—
3098281
—
MA
01
—
J12956
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/12/2006
Last updated
07/08/2007
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