Individual
MADHAVI CHILAKAMARRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8233 GLENCARIN BLVD, FORT WAYNE, IN 46804-5784
(260) 425-5470
(260) 425-5475
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01056497A
IN
207R00000X
Internal Medicine Physician
Primary
01056497A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200248200A
—
IN
Enumeration date
07/19/2005
Last updated
04/22/2025
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