Dommaraju, Chandra B.

Dommaraju, Chandra B. is an individual health care provider with primary practice located at 1400 Us Highway 61 Ste 260 , Festus MO 63028-4101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Dommaraju, Chandra B. can be contacted via phone (636) 933-2344.

Contact Information

Primary practice address
1400 Us Highway 61 Ste 260 Festus MO 63028-4101
Phone: (636) 933-2344
Fax: (636) 937-9031
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X MO106962 Missouri
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 106962 Missouri

Profile Details

NPI number 1255361135
LBN Legal business name Dommaraju, Chandra B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Apr 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255361135 NPPES
Missouri MEDICAID 205115322

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