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Individual
KISHORE R. PATSAMATLA
Active
Individual
KISHORE R. PATSAMATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME97967
FL
207R00000X
Internal Medicine Physician
TP339
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11199529
CAQH
—
Enumeration date
05/05/2006
Last updated
12/09/2019
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