Individual
DR. KRISHNA C MALINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8075 N SHADELAND AVE, #200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
(317) 621-8501
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01067505A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01067505A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
036107040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316998578
NPI GROUP PRACTICE
—
01
—
1616378
BCBS
IL
01
—
K40685
MEDICARE PIN-LOCALITY 15
IL
01
—
K40686
MEDICARE PIN-LOCALITY 16
IL
01
—
P00427560
RRMC-LOCALITY 15
IL
01
—
P00798870
RR MEDICARE PTAN
IN
01
—
P01214659
RR MEDICARE PTAN
IN
Enumeration date
06/13/2006
Last updated
06/14/2021
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