Individual
MR. SIVANTHAN BALACHANDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
834 FARRAR DRIVE, CONWAY, SC 29526
(843) 347-9487
(843) 347-9574
Mailing address
834 FARRAR DRIVE, CONWAY, SC 29526
(843) 347-9487
(843) 347-9574
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
22373
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1049
—
SC
Enumeration date
11/21/2006
Last updated
07/08/2007
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