R S BALBOA MDPC (NPI# 1801024807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801024807 |
| Entity Type | Organization |
| Organization Name | R S BALBOA MDPC |
| Practice Address |
1201 Stone St Ste 5 Port Huron MI 48060-3563 |
| Practice Telephone | 8109669556 |
| Practice Fax Number | 8109664898 |
| Mailing Telephone | 8109669556 |
| Mailing Fax Number | 8109664898 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-12-15 |
| Authorized Official Name | DR. RONALDO S BALBOA (OWNER) |
| Authorized Official Telephone | 8109669556 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | RB028997 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | 110094613 | 01 |
| MI | BCBSM | 0740374 | 01 |
| MI | 1006297 | 05 |
| Street Address |
1201 STONE ST STE 5 |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-3563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992202998 | Jaclyn Kamidoi | Nurse Practitioner | 1201 Stone St Ste 5, Port Huron, MI 48060-3563 | 2018-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700131505 | Victor Velocci | Internal Medicine | 1231 Pine Grove Ave Ste 2a, Port Huron, MI 48060-3500 | 2012-07-17 |
| 1326230970 | Associates for Internal Medicine, P.C. | Internal Medicine | 1216 Richardson St, Port Huron, MI 48060-3549 | 2007-08-16 |
| 1831157056 | Anil R Patel | Internal Medicine | 1205 Richardson St, Port Huron, MI 48060-3548 | 2006-05-04 |
| 1689643496 | Charbal B Bazo | Internal Medicine | 1641 10th St, Suite B, Port Huron, MI 48060-5844 | 2006-03-15 |
| 1265415285 | Emad Daher | Internal Medicine | 1210 10th Ave, Port Huron, MI 48060-3406 | 2005-11-23 |
| 1538153176 | Riad Robert Hajjar | Internal Medicine | 1201 Stone St, Ste. 5, Port Huron, MI 48060-3563 | 2005-09-09 |
| 1255967667 | Blue Water Internal Medicine, PC | Internal Medicine | 1210 10th Ave, Port Huron, MI 48060-3406 | 2020-03-17 |
| 1285279919 | Hospitalist Medicine Physicians of Michigan - Port Huron, Pllc | Internal Medicine | 1221 Pine Grove Ave, Port Huron, MI 48060-3511 | 2019-11-18 |
| 1285092767 | Prime Healthcare Foundation, Inc | Internal Medicine | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2016-01-29 |
| 1366825986 | East Michigan Hospitalists Pllc | Internal Medicine | 1217 Kearney St, Suite 2, Port Huron, MI 48060-3571 | 2015-07-01 |
| Find all providers in PORT HURON | ||||
| City | PORT HURON |
| Zip Code | 48060 |
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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.