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Individual

DALE A BALKOVEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
15003 TURNEY RD, MAPLE HEIGHTS, OH 44137-4730
(216) 663-7753
(216) 663-0897
Mailing address
15003 TURNEY ROAD, MAPLE HEIGHTS, OH 44137
(216) 663-7753
(216) 663-0897

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34003692
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000136583
ANTHEM
OH
05
0588645
OH
01
080039459
RAILROAD MEDICARE
OH
01
341682240BA02
EMERALD
OH
01
9000017231
HMP
OH
01
T03692
SUMMA
OH
Enumeration date
10/03/2006
Last updated
01/18/2011
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