Provider Demographics
NPI:1790877546
Name:RAO, SANJAI C (DO)
Entity Type:Individual
Prefix:DR
First Name:SANJAI
Middle Name:C
Last Name:RAO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 W VILLAGE GREEN DR STE 109
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4876
Mailing Address - Country:US
Mailing Address - Phone:804-322-7800
Mailing Address - Fax:833-637-1610
Practice Address - Street 1:5102 W VILLAGE GREEN DR STE 109
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4876
Practice Address - Country:US
Practice Address - Phone:804-322-7800
Practice Address - Fax:866-493-2807
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022045032084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I45237Medicare UPIN
018409T34Medicare ID - Type Unspecified