Provider Demographics
NPI:1386854651
Name:HIRISAVE KRISHNA, BIPINCHANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:BIPINCHANDRA
Middle Name:
Last Name:HIRISAVE KRISHNA
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 1:1325 SATELLITE BLVD NW STE 400
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5299
Mailing Address - Country:US
Mailing Address - Phone:678-263-3080
Mailing Address - Fax:678-496-9863
Practice Address - Street 1:1325 SATELLITE BLVD NW STE 400
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5299
Practice Address - Country:US
Practice Address - Phone:678-263-3080
Practice Address - Fax:678-496-9863
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010880722084P0800X
MN537132084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry