Individual
DR. KRISHNAN POTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. PC
Contact information
Practice address
8300 BROADWAY, SUITE B, MERRILLVILLE, IN 46410-8602
(219) 769-4616
Mailing address
8300 BROADWAY, SUITE B, MERRILLVILLE, IN 46410
(219) 769-4616
(219) 736-0719
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01025043A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100158100
—
IN
Enumeration date
08/01/2006
Last updated
03/24/2015
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