Organization
BANMAHA PC
Active
Organization
BANMAHA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BALKISSOON A MAHARAJH MD (PYSICIAN)
(814) 536-9715
Entity
Organization
Contact information
Practice address
1015 FRANKLIN ST, JOHNSTOWN, PA 15905-4155
(814) 536-9715
(814) 539-6138
Mailing address
1015 FRANKLIN ST, LEVEL A, JOHNSTOWN, PA 15905-4155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD051194L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019472520002
—
PA
Enumeration date
06/16/2006
Last updated
04/20/2008
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