Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 43994 | GA |
NPI | 1003870577 |
---|---|
Provider Name | Krishna Eechampati |
First Address | Kennesaw, GA 30144-3646 |
Second Address | Kennesaw, GA 30144-3646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 25/06/2021 |