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Organization

MICHAEL C BALOGA DPM, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL C BALOGA, DPM,PC DPM, PC (OWNER DR)
(570) 654-4371
Entity
Organization

Contact information

Practice address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2768
(570) 654-4371
(570) 654-0455
Mailing address
810 WYOMING AVE, WEST PITTSTON, PA 18643-2768
(570) 654-4371
(570) 654-0455

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003071L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003071L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1028012370001
PA
Enumeration date
02/08/2008
Last updated
01/13/2014
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