Basic Information
| Provider Information | |||||||||
| NPI: | 1245235167 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALOGH | ||||||||
| FirstName: | TAMAS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 249 | ||||||||
| Address2: | |||||||||
| City: | YADKINVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270550249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366794963 | ||||||||
| FaxNumber: | 3366792549 | ||||||||
| Practice Location | |||||||||
| Address1: | 708 S SOUTH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | MOUNT AIRY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367866146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 08/16/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 9600446 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207UN0901X | 9600446 | NC | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 1434017 | 01 | NC | UNITED HEALTHCARE | OTHER | 2702499 | 01 | NC | AETNA HMO | OTHER | 5255420 | 01 | NC | AETNA PPO | OTHER | 66909 | 01 | NC | MEDCOST | OTHER | 8912888 | 05 | NC | MEDICAID | 137861 | 01 | NC | SOUTHCARE PPO | OTHER | 16442 | 01 | NC | PARTNERS MEDICARE | OTHER | 110141504 | 01 | NC | MEDICARE RAILROAD | OTHER | 111397 | 01 | NC | CIGNA | OTHER | 12888 | 01 | NC | BCBS OF NC | OTHER | 377877 | 01 | NC | MAMSI | OTHER |