Provider Demographics
NPI:1033349790
Name:PASALA, KRISHNA KAMAL (MD,)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:KAMAL
Last Name:PASALA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 DU RHU DR
Mailing Address - Street 2:APARTMENT 1602
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 DU RHU DRIVE, APT 1602
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:AL
Practice Address - Zip Code:36608-5509
Practice Address - Country:US
Practice Address - Phone:859-806-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.31902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine