Provider Demographics
NPI:1275608853
Name:MEKA, RAO R (MD)
Entity Type:Individual
Prefix:DR
First Name:RAO
Middle Name:R
Last Name:MEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1518 PROFESSIONAL PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830
Mailing Address - Country:US
Mailing Address - Phone:334-321-0600
Mailing Address - Fax:334-321-0063
Practice Address - Street 1:14 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854
Practice Address - Country:US
Practice Address - Phone:334-756-0005
Practice Address - Fax:334-756-0008
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13044207R00000X
LA82589207RG0100X
GA033865207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000024978Medicaid
AL51024978OtherBC
GA00346354BOtherGA MEDICAID
AL24978Medicare ID - Type Unspecified
AL000024978Medicaid