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Individual

JASON BALKO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4000
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
50825
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2601038000
WV
Enumeration date
03/07/2006
Last updated
07/08/2007
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