MEDICARE: SUBHA KRISHNAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	57011197	OH
2	207Q00000X	Family Medicine Physician	01067440	IN
3	207Q00000X	Family Medicine Physician	01067440A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841465994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUBHA KRISHNAN M.D.

Provider Business Mailing Address
First Line	:	2330 S DIXON RD
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-6434
Country	:	US
Telephone Number	:	765-455-5400
Fax Number	:	765-865-3826

Provider Business Practice Location Address
First Line	:	9460 E 146TH ST
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4966
Country	:	US
Telephone Number	:	317-338-9688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	03/16/2026

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