Individual
IAN C BALFOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
738 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4462
(404) 256-2593
Mailing address
2835 BRANDYWINE RD STE 300, ATLANTA, GA 30341-5540
(404) 256-2593
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R4D25
MO
2080P0202X
Pediatric Cardiology Physician
Primary
R4D25
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201961901
—
MO
05
—
700216987A
—
GA
Enumeration date
09/13/2006
Last updated
01/21/2021
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