Provider Demographics
NPI:1558760009
Name:RAO, ASHUTOSH
Entity Type:Individual
Prefix:
First Name:ASHUTOSH
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ASHUTOSH
Other - Middle Name:
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH, PHD
Mailing Address - Street 1:10903 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1058
Mailing Address - Country:US
Mailing Address - Phone:301-279-9144
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1058
Practice Address - Country:US
Practice Address - Phone:301-279-9144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist