Most Relevant Information
Provider Data
| NPI Number: | 1003265455 |
| Provider Name: | ANURADHA G BOMMAKANTI M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 01087946B |
Most Important Dates
| Enumeration Date: | 06/07/2016 |
| Last Updated: | 08/09/2022 |
Provider Practice Location
7950 W JEFFERSON BLVD
FORT WAYNE
IN
468044140
Practice Location Phone/Fax
| Phone: | 2604357001 |
| Fax: |
Provider Mailing Location
7950 W JEFFERSON BLVD
FORT WAYNE
IN
468044140
Provider Mailing Phone/Fax
| Phone: | 2604357001 |
| Fax: |
Suggested EMR
Internist EMR