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General NPI Number Information
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NPI Number | 1164954137
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Entity Type | Individual
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Provider Name | GOPIKA RADHA KRISHNA MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 2665 N DECATUR RD
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City | DECATUR
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State | GA
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Zip | 30033-6149
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Country | US
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Telephone | 914-886-2746
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Fax |
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Provider Business Mailing Address
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Address Line | 69 JESSE HILL JR DR SE GLENN BUILDING, 4TH FLOOR
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City | ATLANTA
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State | GA
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Zip | 30303-3033
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Country | US
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Telephone | 404-251-8812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 2023-01773
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207VC0300X
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Taxonomy Name | Complex Family Planning Physician
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License Number | 101192
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License Number State | GA
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