Provider Demographics
NPI:1285947473
Name:KERI, KRISHNA CHAITANYA (MD)
Entity type:Individual
Prefix:
First Name:KRISHNA CHAITANYA
Middle Name:
Last Name:KERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KRISHNA
Other - Middle Name:C
Other - Last Name:KERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1026 GOODYEAR AVE STE 302B
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1194
Mailing Address - Country:US
Mailing Address - Phone:256-485-0899
Mailing Address - Fax:866-265-9563
Practice Address - Street 1:1026 GOODYEAR AVE STE 302B
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1194
Practice Address - Country:US
Practice Address - Phone:256-485-0899
Practice Address - Fax:866-265-9563
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56880207RN0300X
ALMD.40951207RN0300X
MDP25848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine