Provider Demographics
NPI:1245606151
Name:SCHOSSOW, RETURI SARADA RAO (PA-C, MMS)
Entity type:Individual
Prefix:
First Name:RETURI
Middle Name:SARADA RAO
Last Name:SCHOSSOW
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1413 CARPENTER FLETCHER RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2007
Mailing Address - Country:US
Mailing Address - Phone:919-544-6461
Mailing Address - Fax:919-361-2487
Practice Address - Street 1:1413 CARPENTER FLETCHER RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2007
Practice Address - Country:US
Practice Address - Phone:919-544-6461
Practice Address - Fax:919-361-2487
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-058363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant