GWEN ELIZABETH BALOG (NPI# 1578045225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578045225 |
| Entity Type | Individual |
| Full Name | GWEN ELIZABETH BALOG |
| Practice Address |
21710 Behring Rd Hillman MI 49746-9103 |
| Practice Telephone | 9893067253 |
| Mailing Telephone | 9893067253 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | HEALTHCARE PROVIDERS SERVICE ORGANIZATION | 0651445599-8 | 01 |
| Street Address |
21710 BEHRING RD |
| City | HILLMAN |
| State | MI |
| Zip Code | 49746-9103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437426731 | Thunder Bay Community Health Service, Inc | Clinic/Center | 631 Caring Street, Hillman, MI 49746 | 2011-11-30 |
| 1659379808 | Richard Neal Olree Jr. | Chiropractor | 311 State Street, Hillman, MI 49746 | 2005-07-12 |
| 1629107552 | Thunder Bay Community Health Service, Inc | Family Medicine | 15774 State Street, Hillman, MI 49746 | 2007-03-05 |
| 1215983556 | Amy L Kane | Nurse Practitioner | 15774 State St, Hillman, MI 49746-0427 | 2006-05-26 |
| 1942253851 | Thunder Bay Community Health Service, Inc | Clinic/Center | 15774 Sate Street, Hillman, MI 49746-0427 | 2006-05-19 |
| 1669681748 | Jemellee Perpetua Jacala-tadian | Family Medicine | 15774 State Street, Hillman, MI 49746-0427 | 2007-05-22 |
| 1104951938 | Rebecca N Litzner | Social Worker | 15774 State Street, Hillman, MI 49746-0427 | 2007-02-22 |
| 1003964255 | Carolyn S Koppenol | Psychiatry & Neurology | 15774 State Street, Hillman, MI 49746-0427 | 2007-01-06 |
| 1538404660 | Ruth Chew | Obstetrics & Gynecology | 18600 Red Pine Dr, Hillman, MI 49746-7920 | 2012-11-29 |
| 1033691175 | Abigail R Macarthur | Physician Assistant | 15774 State St, Hillman, MI 49746-7961 | 2018-09-05 |
| Find all providers in zip 49746 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648940 | Danielle Johne | Student in an Organized Health Care Education/Training Program | 1623 W Sharon Rd Sw, Fife Lake, MI 49633-7214 | 2020-11-01 |
| 1285234062 | Christopher Michael Kemp | Student in an Organized Health Care Education/Training Program | 1710 Hermitage Rd, Ann Arbor, MI 48104-4503 | 2020-10-29 |
| 1326647728 | Sevcan Turk | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Uh B2-a209, Dept. of Radiology, Neuroradiology Division, Ann Arbor, MI 48109-5030 | 2020-10-19 |
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1083221345 | Katelynn Ann Millard | Student in an Organized Health Care Education/Training Program | 3710 Tartan Cir, Portage, MI 49024-4094 | 2020-09-29 |
| 1952918377 | Ereny Demian | Student in an Organized Health Care Education/Training Program | 443 Phillips Ave, Clawson, MI 48017-1546 | 2020-09-29 |
| 1629685151 | Nicole Hiltner | Student in an Organized Health Care Education/Training Program | 391 Quail Ridge Ct, Waterford, MI 48327-4332 | 2020-09-29 |
| 1306453303 | Eddie D Williams | Student in an Organized Health Care Education/Training Program | 507 Pearl St, Ypsilanti, MI 48197-2076 | 2020-09-24 |
| 1538774849 | Grace Frederickson | Student in an Organized Health Care Education/Training Program | 820 Meadow Dr, Wayland, MI 49348-1369 | 2020-09-14 |
| 1215541685 | Rebecca Frey | Student in an Organized Health Care Education/Training Program | 3955 Mayfair St, Dearborn Heights, MI 48125-3039 | 2020-09-03 |
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| 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.