Provider Demographics
NPI:1326118225
Name:RAO, ANANTHA K (MD)
Entity Type:Individual
Prefix:MR
First Name:ANANTHA
Middle Name:K
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6495 NEW HAMPSHIRE AVE
Mailing Address - Street 2:190
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3245
Mailing Address - Country:US
Mailing Address - Phone:301-445-4430
Mailing Address - Fax:301-445-3753
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE
Practice Address - Street 2:190
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:301-445-4430
Practice Address - Fax:301-445-3753
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDMD13092207RC0000X, 207RI0011X
DCD0027426207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028971000Medicaid
MD190155Medicare PIN
MD028971000Medicaid
DC190155S44Medicare PIN