Basic Information
| Provider Information | |||||||||
| NPI: | 1679568927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALOURIS | ||||||||
| FirstName: | CHRIST | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 STONEWOOD DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150907376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249404001 | ||||||||
| FaxNumber: | 7249404036 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 STONEWOOD DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150907376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123645282 | ||||||||
| FaxNumber: | 4123643690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 08/28/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD035708E | PA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.