Healthcare Provider Details

I. General information

NPI: 1144420712
Provider Name (Legal Business Name): ARUN KRISHNAMOORTHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW SUITE 3000
ATLANTA GA
30309-1796
US

IV. Provider business mailing address

95 COLLIER RD NW SUITE 3000
ATLANTA GA
30309-1796
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5140
  • Fax: 404-605-6759
Mailing address:
  • Phone: 404-605-5140
  • Fax: 404-605-6759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number075817
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number075817
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: