Provider Demographics
NPI:1003846056
Name:YARLAGADDA, CHAKRI (MD)
Entity Type:Individual
Prefix:
First Name:CHAKRI
Middle Name:
Last Name:YARLAGADDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SRINIVASA
Other - Middle Name:CHAKRAVARTHY
Other - Last Name:YARLAGADDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1001 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1003
Mailing Address - Country:US
Mailing Address - Phone:330-747-6446
Mailing Address - Fax:330-747-6843
Practice Address - Street 1:1001 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1003
Practice Address - Country:US
Practice Address - Phone:330-747-6446
Practice Address - Fax:330-747-6843
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077942-Y207RC0000X
OH35.077942207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH131030OtherMEDICARE PTAN
OH2176970Medicaid
OHH131030OtherMEDICARE PTAN