Organization
BALI SURGICAL PRACTICE PLLC
Active
Other names
Charleston Surgical Arts
Organization subpart
No
Provider details
NPI number
Authorized official
VEDA AMBER EVANS (BILLING MANAGER)
(304) 346-2254
Entity
Organization
Contact information
Practice address
400 COURT ST STE 203, CHARLESTON, WV 25301-1653
(304) 346-2254
(304) 346-3184
Mailing address
400 COURT ST STE 203, CHARLESTON, WV 25301-1653
(304) 346-2254
(304) 346-3184
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001834802
BLUE CROSS
WV
01
—
1689670069
INDIVIUAL NPI
WV
05
—
3810009656
—
WV
Enumeration date
02/02/2007
Last updated
09/04/2024
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