Individual
ETHAN BALK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 WASHINGTON ST, BOX 63, BOSTON, MA 02111-1526
(617) 636-3282
Mailing address
750 WASHINGTON STREET BOX 63, NEW ENGLAND MEDICAL CENTER, BOSTON, MA 02111
(617) 636-3282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
77179
MA
Other
Enumeration date
06/01/2006
Last updated
07/08/2007
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