Provider Demographics
NPI:1609822907
Name:RAO, SANKINENI J (MD)
Entity Type:Individual
Prefix:
First Name:SANKINENI
Middle Name:J
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4000 MITCHELLVILLE RD STE 422
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3104
Mailing Address - Country:US
Mailing Address - Phone:301-262-9872
Mailing Address - Fax:301-262-2730
Practice Address - Street 1:4000 MITCHELLVILLE RD STE 422
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716
Practice Address - Country:US
Practice Address - Phone:201-262-9872
Practice Address - Fax:301-262-2730
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0034525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD275581500Medicaid
MD275581500Medicaid
MDD09662Medicare UPIN