Individual
DR. KRISHNA GUNDABOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
987680 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-7680
(402) 559-8052
(402) 559-6520
Mailing address
987680 NEBRASKA MEDICAL CENTER, OMAHA, NE 68198-6520
(402) 559-8052
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
106238
MN
207RH0003X
Hematology & Oncology Physician
Primary
27263
NE
207RH0003X
Hematology & Oncology Physician
55639
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
SD
Enumeration date
02/20/2012
Last updated
10/01/2014
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