Provider Demographics
NPI:1992909568
Name:LAKSHMAN, KISHORE MATTAPPILLY (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:MATTAPPILLY
Last Name:LAKSHMAN
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
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Mailing Address - Street 1:289 PLEASANT ST
Mailing Address - Street 2:SUITE 604
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-646-7710
Mailing Address - Fax:508-646-7714
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:SUITE 604
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-646-7710
Practice Address - Fax:508-646-7714
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA232520207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism