Furqan Pervez Balouch, DO
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Du Bois, PA
NPI 1922700533 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1922700533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- OT023480 (PA)
- Practice address
- 145 Hospital Ave Ste 315
Du Bois, PA 15801-1465 - Phone
- (814) 503-4305
- Fax
- (814) 503-4307
- NPI assigned
- Mar 20, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240925001007 | PA | Order and Referring Only - Family Practice |
6608234414 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS025237 | PA | MD | Family Medicine Physician |
| OT023480 | PA | MD | Family Medicine Physician |
| H0104522 | MD | MD | General Practice Physician |
| 0102209607 | VA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OT023480 | PA | Yes |
| General Practice Physician | 208D00000X | 0102209607 | VA | |
| Family Medicine Physician | 207Q00000X | OT023480 | PA | |
| General Practice Physician | 208D00000X | H0104522 | MD | |
| Family Medicine Physician | 207Q00000X | OS025237 | PA |
Addresses
Primary practice location
145 Hospital Ave Ste 315
Du Bois, PA 15801-1465
Mailing address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4200
Other providers in Du Bois, PA
- Amanda Rae Baker
- Gregory Baker
- Jenmina R. Baker
- Cory I Baldwin
- Rachel Kathleen Ball
- Indraneel Banerjee
- John Samuel Banerji
- Madison Banko
- Amy Marie Bankovic
- Sandeep Bansal
All providers in Du Bois, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.