Provider Demographics
NPI:1356504245
Name:RAO, ANNE PRATYUSHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:PRATYUSHA
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:PRATYUSHA
Other - Last Name:REGULAGADDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18210 ROCKLAND DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1488
Mailing Address - Country:US
Mailing Address - Phone:301-791-7820
Mailing Address - Fax:
Practice Address - Street 1:319 E ANTIETAM ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5701
Practice Address - Country:US
Practice Address - Phone:301-790-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066228208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics