Provider Demographics
NPI:1710927090
Name:RAO, TANGADA PREMA SUDHA (MD)
Entity Type:Individual
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First Name:TANGADA
Middle Name:PREMA SUDHA
Last Name:RAO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:MCGUIRE VA MEDICAL CENTER, DEPT OF RHEUMATOLOGY (111M)
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249
Mailing Address - Country:US
Mailing Address - Phone:804-675-5470
Mailing Address - Fax:804-675-5318
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:MCGUIRE VA MEDICAL CENTER, DEPT OF RHEUMATOLOGY (111M)
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5470
Practice Address - Fax:804-675-5318
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101048709207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology