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1861652463
TUCKER G. BALAM
SOUTH BEND, IN
NPI
1861652463
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 02003535A)
Enumeration Date
2008-06-17
Last Update Date
2021-03-30
Business Address
TUCKER G. BALAM DO
714 N MICHIGAN ST
SOUTH BEND, IN 46601-1035
Phone number: 574-647-7477
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Mailing Address
TUCKER G. BALAM DO
710 N NILES AVE
SOUTH BEND, IN 46617-1924
Phone number: 574-647-1610
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