Active NPI
Muna Balkash, M.D.
- Pediatrics Physician
- Jackson, MI
National Provider Identifier
1073992699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301069485
- Practice address
- 4645 Eagle Dr
Jackson, MI 49201-9748 - Phone
- (517) 783-5508
- Fax
- (517) 783-5508
- NPI assigned
- May 28, 2015
- Last updated
- May 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301069485 | MI | Primary |
Addresses
Primary practice location
4645 Eagle Dr
Jackson, MI 49201-9748
Mailing address
4645 Eagle Dr
Jackson, MI 49201-9748
Phone (517) 783-5508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301069485 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1073992699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4645 EAGLE DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019748",
"telephone_number": "517-783-5508",
"fax_number": "517-783-5508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4645 EAGLE DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019748",
"telephone_number": "517-783-5508",
"fax_number": "517-783-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALKASH",
"first_name": "MUNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-28",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301069485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.