Balla, Ashfaq S.

Balla, Ashfaq S. is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Balla, Ashfaq S. can be contacted via phone (508) 856-3155.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Fax: (508) 856-3111
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 242372 Massachusetts

Profile Details

NPI number 1740228220
LBN Legal business name Balla, Ashfaq S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Nov 17th, 2020 - about 4 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 1740228220 NPPES
Massachusetts MEDICAID 110084568A

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