Individual
BALAKRISHNA BANGALORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 REID PKWY, ANESTHESIA DEPARTMENT, RICHMOND, IN 47374-1157
(765) 935-8747
(765) 983-3008
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8747
(765) 983-3008
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01063540
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000621757
ANTHEM
IN
05
—
0067317
—
OH
05
—
200861770
—
IN
Enumeration date
05/25/2007
Last updated
05/12/2021
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