Provider Demographics
NPI:1912932815
Name:SETTY, BALA A (MD)
Entity type:Individual
Prefix:DR
First Name:BALA
Middle Name:A
Last Name:SETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:33116 PALMER RD
Mailing Address - Street 2:D
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5524
Mailing Address - Country:US
Mailing Address - Phone:734-729-4343
Mailing Address - Fax:734-729-0222
Practice Address - Street 1:33116 PALMER RD
Practice Address - Street 2:D
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5524
Practice Address - Country:US
Practice Address - Phone:734-729-4343
Practice Address - Fax:734-729-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301035467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2908228321OtherBCBSM INDIVIDUAL
MI2928321OtherDME
MIF02009Medicare UPIN
MI2908228321OtherBCBSM INDIVIDUAL