DR. MICHAEL BALY (NPI# 1588040554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588040554 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL BALY |
| Credential | PH.D. |
| Practice Address |
1132 Annapolis Rd Suite 200 Odenton MD 21113-1647 |
| Mailing Address |
2931 E Biddle St Patient Accounting Baltimore MD 21213-3939 |
| Practice Telephone | 4108741813 |
| Practice Fax Number | 4108741818 |
| Mailing Telephone | 4439231886 |
| Mailing Fax Number | 4439231895 |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
1132 ANNAPOLIS RD SUITE 200 |
| City | ODENTON |
| State | MD |
| Zip Code | 21113-1647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073591665 | Wanda Rivera | Internal Medicine | 1132 Annapolis Rd, Odenton, MD 21113 | 2006-01-04 |
| 1811497860 | Justin Marcus Luckadue | Pharmacist | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2018-02-16 |
| 1053835991 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1132 Annapolis Rd, Odenton, MD 21113-1602 | 2017-08-02 |
| 1588069041 | Sarah Foote | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113 | 2014-10-27 |
| 1699176149 | Erin Christine Gonzalez | Nurse Practitioner | 1132 Annapolis Rd, Suite 201, Odenton, MD 21113-1647 | 2014-09-15 |
| 1760881494 | Physiotherapy Associates | Clinic/Center | 1132 Annapolis Rd, Suite 101, Odenton, MD 21113-1647 | 2014-08-19 |
| 1346678992 | Ashley Marie Zinalabedini | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2013-10-17 |
| 1548531767 | Naomi Rebecca Rios | Pediatrics | 1132 Annapolis Rd, Suite 201, Odenton, MD 21113-1647 | 2012-01-19 |
| 1689958035 | Kimberly Crim | Nurse Practitioner | 1132 Annapolis Rd, Odenton, MD 21113 | 2011-10-04 |
| 1740589100 | Susan Drum | Pharmacist | 1132 Annapolis Rd, Odenton, MD 21113-1647 | 2011-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938599 | Dmv Community Health Services LLC | Clinic/Center | 87778 Pine Orchard Parkway, Odenton, MD 21113 | 2018-07-11 |
| 1285125997 | Edward Lashawn Harvey | Specialist | 207 Ammunition Ave, Odenton, MD 21113 | 2018-05-29 |
| 1275041394 | Aimee Kathleen Olivera Sanchez | Social Worker | 2150 Colonel Way, Odenton, MD 21113 | 2018-01-11 |
| 1891214714 | Bincy Kuttiplackal Mathai | Dentist | 1135 Annapolis Road, Odenton, MD 21113 | 2017-09-12 |
| 1730601949 | Amanda Mary Jackiewicz | Physician Assistant | Greater Maryland Pain Management, 1130 Annapolis Rd Suite 100, Odenton, MD 21113 | 2017-07-10 |
| 1346771235 | Pattrena Reid | Respiratory Therapist, Registered | 115 Bragg Blvd, Odenton, MD 21113 | 2017-03-23 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1730431321 | Orthopedic Physicians of Annapolis LLC | Prosthetic/Orthotic Supplier | 1106 Annapolis Road, Suite 130, Odenton, MD 21113 | 2012-10-08 |
| 1275869463 | Olubukola Fakunle | Pharmacist | 2294 Blue Water Blvd, Weis Pharmacy, Odenton, MD 21113 | 2009-10-23 |
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| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004832 | Kehinde Bolajoko Abioye | Clinical Neuropsychologist | 10420 Little Patuxent Pkwy Ste 250, Columbia, MD 21044-3638 | 2020-05-12 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1790207967 | Allison Morgan Hecht | Clinical Neuropsychologist | 101 E Chesapeake Ave Ste 202, Towson, MD 21286-5362 | 2017-07-10 |
| 1902333107 | Keenan Alexander Walker | Clinical Neuropsychologist | Phipps, Room 446, 600 North Wolfe Street, Baltimore, MD 21287 | 2017-05-18 |
| 1467804393 | Emma Cole | Clinical Neuropsychologist | 7621 Warbler Ln, Derwood, MD 20855-1031 | 2016-07-03 |
| 1184071375 | Shawn Shanee Nelson Schmitt | Clinical Neuropsychologist | 8555 16th St Ste 310, Summit Building, Silver Spring, MD 20910-2802 | 2016-05-18 |
| 1528421625 | Ellen Iscoe | Clinical Neuropsychologist | 3907 Livingston St, Hyattsville, MD 20781-1740 | 2016-04-05 |
| 1174930515 | Alyssa Levisohn | Clinical Neuropsychologist | 714 Kersey Rd, Silver Spring, MD 20902-3061 | 2014-07-17 |
| 1588008510 | Jacqueline R Weaver | Clinical Neuropsychologist | 2200 Kernan Dr Ofc 1219, Baltimore, MD 21207-6665 | 2013-04-21 |
| 1275875221 | Matthew Lawrence Cohen | Clinical Neuropsychologist | Meyer 218 The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-0005 | 2013-03-17 |
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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.