Individual
DR. ANURADHA G BOMMAKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
Mailing address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01087946B
IN
207R00000X
Internal Medicine Physician
E-19237
AR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01087946A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
E-19237
AR
207RP1001X
Pulmonary Disease Physician
01087946A
IN
207RP1001X
Pulmonary Disease Physician
E-19237
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2016
Last updated
04/24/2025
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