Provider Demographics
NPI:1629567508
Name:BALDELLI, LUKE THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:THOMAS
Last Name:BALDELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MASON FARM ROAD BIOINFORMATICS BUILDING CB# 7080
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7080
Mailing Address - Country:US
Mailing Address - Phone:984-974-5050
Mailing Address - Fax:
Practice Address - Street 1:130 MASON FARM ROAD
Practice Address - Street 2:BIOINFORMATICS BUILDING CB# 7080
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7080
Practice Address - Country:US
Practice Address - Phone:984-974-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC238745390200000X
NC2021-02477207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program