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NPI Code Detail

MEDICARE: SHAKUNTALA KRISHNAMURTHY, MD, PC

MEDICARE: SHAKUNTALA KRISHNAMURTHY, MD, PC
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
1207U00000XNuclear Medicine PhysicianMD10821OR

General Provider Information

NPI Number : 1770678641
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAKUNTALA KRISHNAMURTHY, MD, PC
Provider Business Mailing Address
First Line : PO BOX 23200
Second Line :
City : PORTLAND
State : OR
Zip : 97281-3200
Country : US
Telephone Number : 503-681-1745
Fax Number :
Provider Business Practice Location Address
First Line : 335 SE 8TH AVE
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-4246
Country : US
Telephone Number : 503-681-1745
Fax Number :
Authorized Official
Title or Position : OWNER/MD
Name : SHAKUNTALA KRISHNAMURTHY
Credential : MD
Telephone Number : 503-968-4642
Provider Enumeration Date : 10/04/2006
Last Update Date : 11/30/2007

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