Dr. Latha Balamuniswamy, MD
Family Medicine in Moline, IL. Individual provider (NPI-1).
NPI number1336113992
StatusActive
Last updated in NPPESFeb 5, 2015
Details
- NPI
- 1336113992
- Entity type
- Individual (NPI-1)
- Name
- Dr. Latha Balamuniswamy
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 13, 2006
- Last updated
- Feb 5, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 036087173 | IL | Yes |
| 207Q00000X | Family Medicine | 34452 | IA |
Practice location
106 19th AveSuite 103
Moline, IL 61265-3700
Phone 309-779-7050 · Fax 309-764-6269
Mailing address
106 19th AveSuite 103
Moline, IL 61265-3700
Phone 309-779-7050 · Fax 309-764-6269
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