Provider Demographics
NPI:1649486994
Name:GUMIDYALA, KRISHNA V (MD)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:V
Last Name:GUMIDYALA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5667 PEACHTREE DUNWOODY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1725
Mailing Address - Country:US
Mailing Address - Phone:404-252-2422
Mailing Address - Fax:404-252-6223
Practice Address - Street 1:5667 PEACHTREE DUNWOODY RD STE 220
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1725
Practice Address - Country:US
Practice Address - Phone:404-252-2422
Practice Address - Fax:404-252-6223
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2023-02-06
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Provider Licenses
StateLicense IDTaxonomies
GA064382207X00000X
GA.064382207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery