Individual
DR. KRISHNA DUMMULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
3901 RAINBOW BLVD, MAIL STOP: 4004, KANSAS CITY, KS 66103-2937
(913) 588-6337
(913) 588-6317
Mailing address
3901 RAINBOW BLVD, MAIL STOP: 4004, KANSAS CITY, KS 66103-2937
(913) 588-6337
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0434005
KS
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0434005
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0320000A
MEDICARE PTAN (GROUP)
KS
01
—
032A00020
MEDICARE PTAN (INDIVIDUAL)
KS
05
—
200654260A
—
KS
Enumeration date
05/22/2007
Last updated
04/28/2011
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