Individual
DR. BALAJI RANGARATHNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS SPEECH LANGUAGE PATHOLOGY, GREENVILLE, NC 27834-4300
(252) 744-6104
(252) 744-6148
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10721
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902265457
—
NC
01
—
19GV2
BCBS NC
NC
Enumeration date
02/12/2016
Last updated
10/31/2016
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