Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 21075 | AL |
Y | 207RN0300X | Nephrologist | 36406 | SC |
NPI | 1063449569 |
---|---|
Provider Name | Zipporah Krishnasami |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 14/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009921585 | (05) | AL |
009958275 | (05) | AL |
051515800 | BLUE CROSS (01) | AL |
051515801 | BLUE CROSS (01) | AL |
051523368 | BLUE CROSS (01) | AL |
051553525 | (05) | AL |
P000010241 | RAILROAD MEDICARE (01) | AL |