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NPI Code Detail

MEDICARE: DR. LAKSHMI ISANAKA CHILLAKURU M.D

MEDICARE: DR. LAKSHMI ISANAKA CHILLAKURU M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianD67361MD

General Provider Information

NPI Number : 1184810905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAKSHMI ISANAKA CHILLAKURU M.D
Provider Business Mailing Address
First Line : PO BOX 778
Second Line :
City : EASTON
State : MD
Zip : 21601-8914
Country : US
Telephone Number : 410-763-8787
Fax Number : 443-496-3443
Provider Business Practice Location Address
First Line : 1454 FAIRFIELD LOOP RD
Second Line :
City : CROWNSVILLE
State : MD
Zip : 21032-2006
Country : US
Telephone Number : 410-987-6338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2007
Last Update Date : 12/01/2022

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