Provider Demographics
NPI:1497862569
Name:RAO, GAUTAMI SREERAMOJU (MD,)
Entity Type:Individual
Prefix:DR
First Name:GAUTAMI
Middle Name:SREERAMOJU
Last Name:RAO
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
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Mailing Address - Street 1:10 PROSPECT ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3922
Mailing Address - Country:US
Mailing Address - Phone:603-886-7900
Mailing Address - Fax:603-594-0654
Practice Address - Street 1:10 PROSPECT ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3922
Practice Address - Country:US
Practice Address - Phone:603-886-7900
Practice Address - Fax:603-594-0654
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH8997207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009669Medicaid
F54288Medicare UPIN
NHRE2824Medicare ID - Type Unspecified