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General NPI Number Information
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NPI Number | 1831171891
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Entity Type | Individual
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Provider Name | LAKHMAN L GONDALIA MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 6252 YELLOWSTONE RD
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City | CHEYENNE
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State | WY
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Zip | 82009-3432
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Country | US
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Telephone | 307-778-2015
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Fax | 307-778-7060
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Provider Business Mailing Address
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Address Line | 6252 YELLOWSTONE RD
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City | CHEYENNE
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State | WY
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Zip | 82009-3432
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Country | US
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Telephone | 307-778-2015
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Fax | 307-778-7060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 4234A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 19482
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 37760
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License Number State | CO
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