Provider Demographics
NPI:1366412520
Name:BALFOUR, GUILLERMO ALFRED (MD)
Entity type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:ALFRED
Last Name:BALFOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:STE 238
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-537-1180
Mailing Address - Fax:202-244-7410
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:STE 238
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-537-1180
Practice Address - Fax:202-244-7410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD3823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics