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General NPI Number Information
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NPI Number | 1982688396
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Entity Type | Individual
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Provider Name | SETHU NMN KRISHNAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 1818 RICHARDSON DR STE F
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City | REIDSVILLE
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State | NC
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Zip | 27320-5450
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Country | US
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Telephone | 336-342-4791
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Fax | 336-634-0790
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Provider Business Mailing Address
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Address Line | 1818 RICHARDSON DR STE F
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City | REIDSVILLE
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State | NC
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Zip | 27320-5450
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Country | US
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Telephone | 336-342-4791
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Fax | 336-634-0790
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 31382
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License Number State | NC
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