Individual
DR. RAJESH VENKAT MADDIKUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3802 OAKWOOD MALL DR, EAU CLAIRE, WI 54701-3016
(715) 839-9280
(715) 831-0052
Mailing address
719 W HAMILTON AVE STE B, EAU CLAIRE, WI 54701-6970
(715) 552-9784
(715) 835-6370
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
43822-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001520265
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER( INDIVIDUAL PTAN)
—
01
—
029200103
MEDICARE PROVIDER
WI
05
—
34286000
—
WI
Enumeration date
01/10/2008
Last updated
03/21/2025
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