Provider Demographics
NPI:1205095957
Name:RAO, PRATIBHA PR (MD, MPH)
Entity type:Individual
Prefix:
First Name:PRATIBHA
Middle Name:PR
Last Name:RAO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32778 S ROUNDHEAD DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4851
Mailing Address - Country:US
Mailing Address - Phone:440-914-0018
Mailing Address - Fax:
Practice Address - Street 1:32778 S ROUNDHEAD DR
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-4851
Practice Address - Country:US
Practice Address - Phone:440-914-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40240207R00000X
OH35.092256207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine