Individual
THEODORA G BALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
701 W PRATT ST, 3RD. FLR, BALTIMORE, MD 21201-1023
(410) 328-5881
(410) 328-8552
Mailing address
701 W PRATT ST, 3RD. FLR, BALTIMORE, MD 21201-1023
(410) 328-5881
(410) 328-8552
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0051678
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505700
—
MD
Enumeration date
07/22/2006
Last updated
02/16/2008
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