Healthcare Provider Details

I. General information

NPI: 1861948069
Provider Name (Legal Business Name): NAGA SAI KRISHNA PATIBANDLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR # G805
MOBILE AL
36607-3513
US

IV. Provider business mailing address

5 MOBILE INFIRMARY CIR # G805
MOBILE AL
36607-3513
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2273
  • Fax: 251-435-4884
Mailing address:
  • Phone: 251-435-2273
  • Fax: 251-435-4884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number54879
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD207828
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD207828
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: