Provider Demographics
NPI:1770503468
Name:BALI, AJAY KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:KUMAR
Last Name:BALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AJAY
Other - Middle Name:KUMAR
Other - Last Name:BALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3400 LEBANON PIKE
Mailing Address - Street 2:ALVIN C YORK VA MEDICAL CENTER
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-867-6000
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:ALVIN C YORK VA MEDICAL CENTER ,MEDICINE DEPTT
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-867-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000033972207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease