Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 22892 | OK |
N | 111NI0900X | Internist | 22892 | OK |
Y | 207RN0300X | Nephrologist | 22892 | OK |
NPI | 1063480309 |
---|---|
Provider Name | Pankaj Baluja |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-5417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2006 |
Last Update Date | 16/03/2011 |