Individual
DR. KRISHNENDU GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2014027718
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018087
—
MO
Enumeration date
08/24/2011
Last updated
09/15/2022
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