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1184076168
ANDREW BALAVITCH
ROYAL OAK, MI
NPI
1184076168
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704297101)
Enumeration Date
2016-07-01
Last Update Date
2020-12-15
Business Address
ANDREW BALAVITCH
3601 W 13 MILE RD
ROYAL OAK, MI 48073-6712
Phone number: 248-551-5000
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Mailing Address
ANDREW BALAVITCH
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 48033-3849
Phone number: 947-522-1867
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