Individual
KAVITHA KRISHNAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3815 E BELL RD STE 4100, PHOENIX, AZ 85032-2167
(602) 633-3848
(602) 633-3841
Mailing address
3815 E BELL RD STE 2200, PHOENIX, AZ 85032-2139
(602) 633-3848
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59825
AZ
207Q00000X
Family Medicine Physician
MD00047733
WA
390200000X
Student in an Organized Health Care Education/Training Program
ML20008124
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149726
—
AZ
Enumeration date
03/26/2007
Last updated
11/06/2023
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