Individual
DR. TALLURI BALAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
423 S SOUTH ST, STE 101, MOUNT AIRY, NC 27030-4576
(336) 786-5144
(336) 786-5146
Mailing address
PO BOX 1267, MT AIRY, NC 27030-1267
(336) 786-4522
(336) 789-3025
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
30591
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912732
—
NC
Enumeration date
06/17/2005
Last updated
01/14/2014
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