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Individual

DR. MICHAEL C BALOGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM, PC

Contact information

Practice address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2741
(570) 654-4371
(570) 654-0455
Mailing address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2741
(570) 654-4371
(570) 654-0455

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003071L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003071L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1028012370001
PA
Enumeration date
10/02/2006
Last updated
01/13/2014
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