Peter E. Balsam, MD, Facg

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME46070 Issued in FL

Legal business name

PETER E. BALSAM, MD, FACG

Practice address

4987 S Washington Ave
Titusville, FL 32780-7307

Phone

(321) 264-3330

Fax

(321) 268-2286

NPI assigned

Apr 4, 2007

Last updated

Jan 27, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter E. Balsam, M.D.

Title

Owner

Phone

(321) 264-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NA Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1982726766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4987 S WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807307",
            "telephone_number": "321-264-3330",
            "fax_number": "321-268-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4987 S WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807307",
            "telephone_number": "321-264-3330",
            "fax_number": "321-268-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER E. BALSAM, MD, FACG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "BALSAM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-264-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME46070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE NUMBER",
            "identifier": "46070",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alphonse M Pecoraro, MD
• Taha Peerzada, DMD
• Nicholas Alexander Pefkaros, M.D.
• Steven H Perelmuter, DMD
• Perez & Rivera P L
• Mallory Peterson
• Michael Pfeiffer, D.P.T.
• David Merrill Phillips, R.PH
• Monell Phillips
• Noelle Phillips, PT

• Gastroenterology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.