BALSAM HEALTH OF THE CAROLINAS, PLLC


Address: 607 W Grover St Ste 101, Shelby, NC 28150-2816
Phone: 7048660101

BALSAM HEALTH OF THE CAROLINAS, PLLC (NPI# 1598257750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598257750
Entity Type Organization
Organization Name BALSAM HEALTH OF THE CAROLINAS, PLLC
Practice Address 607 W Grover St Ste 101
Shelby
NC 28150-2816
Mailing Address Po Box 6449
Concord
NC 28027-1525
Practice Telephone 7048660101
Practice Fax Number 7048660103
Mailing Telephone 7048660101
Mailing Fax Number 7048660103
Enumeration Date 2018-06-04
Last Update Date 2018-06-04
Authorized Official Name RADWAN IBRAHIM (OWNER/MEMBER)
Authorized Official Telephone 7049414485
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
9701414 NC Ambulatory Health Care Facilities

Office Location

Street Address 607 W GROVER ST STE 101
City SHELBY
State NC
Zip Code 28150-2816

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City SHELBY
Zip Code 28150

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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