Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2013-02387 | NC |
NPI | 1134198534 |
---|---|
Provider Name | Guha Krishnaswamy |
First Address | Salisbury, NC 28144-2515 |
Second Address | Salisbury, NC 28144-2515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 24/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E39437 | (02) |