Provider Demographics
NPI:1851754469
Name:SHAHNAZ K. RAO MDPA
Entity Type:Organization
Organization Name:SHAHNAZ K. RAO MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-670-8080
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-0292
Mailing Address - Country:US
Mailing Address - Phone:410-670-8080
Mailing Address - Fax:410-670-8054
Practice Address - Street 1:14300 GALLANT FOX LN STE 224
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4033
Practice Address - Country:US
Practice Address - Phone:410-670-8080
Practice Address - Fax:410-670-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty