Individual
DR. CHANDRASHEKHAR YALAMANCHALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11123 PARKVIEW PLAZA DR STE 202, FORT WAYNE, IN 46845-1707
(260) 425-6100
(260) 425-6105
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
01049779A
IN
2080P0214X
Pediatric Pulmonology Physician
Primary
01049779A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200231310
—
IN
05
—
200231310A
—
IN
Enumeration date
07/24/2006
Last updated
10/11/2022
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