Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 50262 | AZ |
N | 207T00000X | Neurosurgeon | BP20028816 | TX |
NPI | 1083863732 |
---|---|
Provider Name | Dr. Chandan Krishna |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 08/09/2020 |