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Individual

KRISHNA ATHOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 475-8787
(513) 475-7348
Mailing address
3200 BURNET AVE, 3 SOUTH CREDENTIALING, CINCINNATI, OH 45229-3019
(513) 475-8787
(513) 475-7348

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35090845
OH
208600000X
Surgery Physician
4301078386
MI
2086S0102X
Surgical Critical Care Physician
Primary
35090845
OH
2086S0127X
Trauma Surgery Physician
35090845
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200908710
IN
05
2811229
OH
05
7100059370
KY
Enumeration date
05/18/2007
Last updated
01/08/2015
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