Provider Demographics
NPI:1932311867
Name:RAO, ANJANI (MD)
Entity Type:Individual
Prefix:
First Name:ANJANI
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42557 WOODWARD AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5206
Mailing Address - Country:US
Mailing Address - Phone:248-322-3088
Mailing Address - Fax:248-322-4175
Practice Address - Street 1:42557 WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5206
Practice Address - Country:US
Practice Address - Phone:248-333-1170
Practice Address - Fax:248-333-1175
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082561207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1962478743OtherGROUP NPI
MI1932311867Medicaid
MI0M89900OtherMEDICARE GROUP PIN
MI1962478743OtherGROUP NPI