Individual
DR. CHANDRALEKHA BOMMAKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 S OAKWOOD RD, OSHKOSH, WI 54904-7944
(920) 223-3400
(920) 223-3404
Mailing address
500 S OAKWOOD RD, OSHKOSH, WI 54904-7944
(920) 223-3400
(920) 223-3404
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31641
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31765700
—
WI
Enumeration date
09/15/2006
Last updated
02/06/2013
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