Provider Demographics
NPI:1770629131
Name:PERSAUD, SMITHA RAO (MD)
Entity Type:Individual
Prefix:
First Name:SMITHA
Middle Name:RAO
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1425 WEATHERLY RD SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-1178
Mailing Address - Country:US
Mailing Address - Phone:256-881-5770
Mailing Address - Fax:256-881-2228
Practice Address - Street 1:1425 WEATHERLY RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-1178
Practice Address - Country:US
Practice Address - Phone:256-881-5770
Practice Address - Fax:256-881-2228
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL000273972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology