Basic Information
| Provider Information | |||||||||
| NPI: | 1093850745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHADRA | ||||||||
| FirstName: | KRISHNENDU | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 GLENWOOD DR | ||||||||
| Address2: | SUITE E-500 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234952635 | ||||||||
| FaxNumber: | 4234952638 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 GLENWOOD DR | ||||||||
| Address2: | SUITE E-500 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234952635 | ||||||||
| FaxNumber: | 4234952638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 06/27/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 060-0003167 | VT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 47130 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.