Individual ProviderWesam BalloukInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address2225 Union Ave, Ste 100, Memphis, TN 38104-4316(901) 726-1161PECOS EnrollmentBased on the most recent information from CMS, provider Wesam Ballouk is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1841291762Provider TypeIndividualFull NameBallouk, WesamCredentialMDGenderMaleSole ProprietorNoEnumeration Date8/2/2005Last Updated2/28/2025Contact InformationPractice LocationPractice Address2225 Union Ave, Ste 100, Memphis, TN 38104-4316Phone(901) 726-1161Fax(901) 726-0161Mailing LocationMailing Address2225 Union Ave, Ste 100, Memphis, TN 38104-4316Phone(901) 726-1161Fax(901) 726-0161Provider TaxonomiesCodeDescriptionLicenseCode207RN0300XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD37027TennesseeProvider IdentifiersIDDescriptionIssuerID3326941DescriptionMedicaidIssuerUnlistedTennessee