Basic Information
| Provider Information | |||||||||
| NPI: | 1437115391 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALUH | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 N. SEVENTH STREET | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172673000 | ||||||||
| FaxNumber: | 7172677414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 12/18/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN221538L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 120420418 | 01 | PA | DEPT OF LABOR | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | G920-0085/85XWCU | 01 | PA | CAREFIRST | OTHER | P00602488 | 01 | PA | RAILROAD MEDICARE | OTHER | 007390383 | 05 | PA | MEDICAID | 258232 | 01 | PA | UNISON | OTHER | 050514 | 01 | PA | MEDICARE GROUP # | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 50075721 | 01 | PA | CAPITAL BLUECROSS | OTHER | RN221538L | 01 | PA | RN LICENSE # | OTHER |