Balaban, Lori W.

Balaban, Lori W. is an individual health care provider with primary practice located at 1011 E Jefferson St , Charlottesville VA 22902-5354. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Balaban, Lori W. can be contacted via phone (434) 296-9161.

Contact Information

Primary practice address
1011 E Jefferson St Charlottesville VA 22902-5354
Phone: (434) 296-9161
Fax: (434) 977-6068
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101049502 Virginia

Profile Details

NPI number 1447232905
LBN Legal business name Balaban, Lori W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Sep 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447232905 NPPES
Virginia MEDICAID 006725813
Virginia Other 010712
Virginia Other 333846
Virginia Other 267039
Virginia Other 52387
Virginia Other 12952600002

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