Provider Demographics
NPI:1033303821
Name:RAO, SUBHOD (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBHOD
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 WATERMARK DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6650
Mailing Address - Country:US
Mailing Address - Phone:770-827-7414
Mailing Address - Fax:
Practice Address - Street 1:850 5TH AVE E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-7419
Practice Address - Country:US
Practice Address - Phone:205-348-1770
Practice Address - Fax:205-348-7216
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.29968207Q00000X
390200000X
GA064251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program