Individual
DR. BAKHTIAR ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1468 MONTREAL RD, TUCKER, GA 30084-6901
(770) 638-1400
(678) 735-4685
Mailing address
1468 MONTREAL RD, TUCKER, GA 30084-6901
(770) 638-1400
(678) 735-4685
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301078954
MI
207RC0000X
Cardiovascular Disease Physician
068877
GA
207RI0011X
Interventional Cardiology Physician
Primary
068877
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068877
GEROGIA LICENSE
GA
Enumeration date
07/24/2006
Last updated
01/09/2013
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