Provider Demographics
NPI:1003014770
Name:KRISHNA INTERNAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:KRISHNA INTERNAL MEDICINE, P.C.
Other - Org Name:WAYAH INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VERSI
Authorized Official - Middle Name:MAL
Authorized Official - Last Name:ARUWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-349-6881
Mailing Address - Street 1:55 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2635
Mailing Address - Country:US
Mailing Address - Phone:828-349-6881
Mailing Address - Fax:828-349-6885
Practice Address - Street 1:55 MEDICAL PARK DR
Practice Address - Street 2:SUITE 116
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2635
Practice Address - Country:US
Practice Address - Phone:828-349-6881
Practice Address - Fax:828-349-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-04
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89136Y4Medicaid
NCG58194Medicare UPIN
NC89136Y4Medicaid