Provider Demographics
NPI:1982040358
Name:RAO, BHARAT KONDRAGUNTA (MD)
Entity Type:Individual
Prefix:
First Name:BHARAT
Middle Name:KONDRAGUNTA
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11315 JOHNS CREEK PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2647
Mailing Address - Country:US
Mailing Address - Phone:770-227-2222
Mailing Address - Fax:770-227-2220
Practice Address - Street 1:11315 JOHNS CREEK PKWY STE 400
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-2647
Practice Address - Country:US
Practice Address - Phone:770-227-2222
Practice Address - Fax:770-227-2220
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67567-20207RG0100X
GA94618207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology