Individual
SHIVA S KRISHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 8TH ST SE, DECATUR, AL 35601-3356
(256) 560-0646
(256) 560-0649
Mailing address
101 WESTOVER CIR STE C, MADISON, AL 35758-4910
(256) 890-0331
(256) 325-1189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00025205
AL
207K00000X
Allergy & Immunology Physician
25205
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025205
AL. STATE LICENSE #
AL
05
—
182367
—
AL
05
—
221879
—
AL
Enumeration date
02/05/2006
Last updated
04/09/2020
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