Organization
MADHAVI CHILAKAMARRI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADHAVI CHILAKAMARRI MD (OWNER)
(260) 490-4416
Entity
Organization
Contact information
Practice address
10102 WOODLAND PLAZA CV # A, FORT WAYNE, IN 46825-1565
(260) 490-4416
Mailing address
10102 WOODLAND PLAZA CV # A, FORT WAYNE, IN 46825-1565
(260) 490-4416
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01056497A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013916394
INDIVIDUAL NPI NUMBER
IN
Enumeration date
10/24/2006
Last updated
08/22/2020
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