Individual
MR. BALA MURUGAN GANESAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103
(610) 402-5369
(610) 402-5959
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD437064
PA
208M00000X
Hospitalist Physician
Primary
MD437064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201979-CAPE
—
NJ
01
—
P00765902
RR MEDICARE
NJ
Enumeration date
05/23/2007
Last updated
05/23/2023
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