Organization
PETER E. BALSAM, MD, FACG
Active
Other names
NA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER E. BALSAM M.D. (OWNER)
(321) 264-3330
Entity
Organization
Contact information
Practice address
4987 S WASHINGTON AVE, TITUSVILLE, FL 32780-7307
(321) 264-3330
(321) 268-2286
Mailing address
4987 S WASHINGTON AVE, TITUSVILLE, FL 32780-7307
(321) 264-3330
(321) 268-2286
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME46070
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46070
MED LICENSE NUMBER
FL
Enumeration date
04/04/2007
Last updated
01/27/2010
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