Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 057528 | GA |
Y | 208000000X | Pediatrician | 057528 | GA |
NPI | 1497702872 |
---|---|
Provider Name | Dr. Vidya Krishnamurthy |
First Address | Alpharetta, GA 30005-4381 |
Second Address | Alpharetta, GA 30005-4381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
553342565A | (05) | GA |