Provider Demographics
NPI:1730721408
Name:KRISHNA PODIATRY GROUP OF GEORGIA
Entity type:Organization
Organization Name:KRISHNA PODIATRY GROUP OF GEORGIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELVADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-806-3731
Mailing Address - Street 1:2864 JOHNSON FERRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8346
Mailing Address - Country:US
Mailing Address - Phone:404-806-3731
Mailing Address - Fax:
Practice Address - Street 1:2864 JOHNSON FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8346
Practice Address - Country:US
Practice Address - Phone:404-806-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty