Individual
DR. SAMUEL BALANA LUAGUE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 N JEFFERSON ST, GALAX, VA 24333-2858
(276) 236-7166
(276) 236-7165
Mailing address
PO BOX 855, GALAX, VA 24333-0855
(276) 236-7166
(276) 236-7165
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25878
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061584
ANTHEM
VA
05
—
6399941
—
VA
01
—
690612W
MEDICAID
NC
Enumeration date
06/21/2005
Last updated
07/08/2007
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