Provider Demographics
NPI:1821300278
Name:BANGALORE KRISHNAPPA, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:BANGALORE KRISHNAPPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7659
Mailing Address - Country:US
Mailing Address - Phone:404-844-3200
Mailing Address - Fax:404-851-6325
Practice Address - Street 1:1200 NORTHSIDE FORSYTH DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7659
Practice Address - Country:US
Practice Address - Phone:404-844-3200
Practice Address - Fax:404-851-6325
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU2052208M00000X, 207RI0011X, 207R00000X
GA070042208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology