Datta, Krishna

Datta, Krishna is an individual health care provider with primary practice located at 2121 Lake Ave , Fort Wayne IN 46805-5100. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Datta, Krishna can be contacted via phone (260) 426-5431.

Contact Information

Primary practice address
2121 Lake Ave Fort Wayne IN 46805-5100
Phone: (260) 426-5431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 01061557 Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01061557A Indiana

Profile Details

NPI number 1427161801
LBN Legal business name Datta, Krishna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Aug 24th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427161801 NPPES
Indiana Other 000000487981 ANTHEM
Indiana Other P00417461 ANTHEM
Indiana MEDICAID 2679936 ANTHEM
Indiana MEDICAID 200830440 ANTHEM

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