Individual
ALI BALTAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 2ND AVE STE 203, BOWLING GREEN, KY 42101-1778
(270) 843-5114
(270) 745-1230
Mailing address
720 2ND AVE STE 203, BOWLING GREEN, KY 42101-1778
(217) 518-6382
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125074501
IL
207RN0300X
Nephrology Physician
Primary
59321
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100981060
—
KY
Enumeration date
07/12/2019
Last updated
06/25/2024
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