Provider Demographics
NPI:1376515643
Name:RAO, KRISHNAMOORTHY BAIKADY (MD)
Entity Type:Individual
Prefix:
First Name:KRISHNAMOORTHY
Middle Name:BAIKADY
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:585-597 MERRIMACK ST
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-746-7778
Mailing Address - Fax:978-970-0359
Practice Address - Street 1:585 MERRIMACK ST
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-746-7778
Practice Address - Fax:978-970-0359
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216072207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
59845OtherFALLON
973042OtherNETWORK HEALTH
0408633OtherUNITED HEALTH CARE
7846502OtherCIGNA
A1440OtherHARVARD PILGRIM HEALTHCAR
MA1305557Medicaid
3320315OtherAETNA
0029032OtherNEIGHBORHOOD HEALTH PLAN
042881348OtherCHOICECARE
J26210OtherBLUE CROSS BLUE SHIELD
042881348OtherBEECH STREET
468563OtherTUFTS
042881348OtherONE HEALTH
042881348OtherUNICARE
59845OtherFALLON
MA1305557Medicaid