Provider Demographics
NPI:1245287507
Name:PAMULAPATI, KRISHNA M (MD)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:M
Last Name:PAMULAPATI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1536 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6525
Mailing Address - Country:US
Mailing Address - Phone:904-475-6318
Mailing Address - Fax:904-232-2381
Practice Address - Street 1:1536 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6525
Practice Address - Country:US
Practice Address - Phone:904-475-6318
Practice Address - Fax:904-232-2381
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-12-06
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Provider Licenses
StateLicense IDTaxonomies
MN48997207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN786822700Medicaid