Provider Demographics
NPI:1568436434
Name:RAO, RAVIPRASAD GOVIND (MD)
Entity Type:Individual
Prefix:
First Name:RAVIPRASAD
Middle Name:GOVIND
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CLIPPER WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229
Mailing Address - Country:US
Mailing Address - Phone:803-699-6544
Mailing Address - Fax:
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6849
Practice Address - Country:US
Practice Address - Phone:803-434-6392
Practice Address - Fax:803-434-4309
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC271832080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine