Individual
MANGALA BALAKRISHNAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
4069 BRIDGEHAMPTON LN, VIRGINIA BEACH, VA 23455-5635
(757) 460-2545
(757) 460-5464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101036371
VA
Other
Enumeration date
02/26/2006
Last updated
07/08/2007
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