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Contact Information

KISHORE R RASAMALLU, MD
12895 KEYSTONE CT
ALPHARETTA, GA30009-1526
 Phone: 210-379-8553
 Fax: 910-900-1239
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for KISHORE R RASAMALLU · (Male)

NPI # 1568667863
Status Active
Credentials MD
Entity Individual
Enumeration date 06/18/2007
Last updated 06/20/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • GA License # 077148
  • PA License # MD432046
  • TX License # M9598
  • PA Medicaid 1020162720001
  • PA Other 1747437 AETNA
  • PA Other 39170 HEALTH PARTNERS
  • PA Other 1988201 HIGHMARK BLUE SHIELD
  • PA Other 2864090000 KEYSTONE IBC
  • PA Other 30046047 KEYSTONE MERCY
  • PA Other 2864090000 PERSONAL CHOICE
Hospital affiliation(s)
  • GWINNETT MEDICAL CENTER - (Acute Care)
    1000 MEDICAL CENTER BOULEVARD
    LAWRENCEVILLE, GA 30045
  • NORTH FULTON REGIONAL HOSPITAL - (Acute Care)
    3000 HOSPITAL BOULEVARD
    ROSWELL, GA 30076
  • NORTHEAST GEORGIA MEDICAL CENTER INC - (Acute Care)
    743 SPRING STREET
    GAINESVILLE, GA 30501
  • NORTHSIDE HOSPITAL CHEROKEE - (Acute Care)
    201 HOSPITAL ROAD
    CANTON, GA 30114
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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