Provider Demographics
NPI:1295752772
Name:RAO, RAMA DEVI (MD)
Entity type:Individual
Prefix:DR
First Name:RAMA
Middle Name:DEVI
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:G4007 W COURT ST
Mailing Address - Street 2:SUITE.F
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3560
Mailing Address - Country:US
Mailing Address - Phone:810-732-8120
Mailing Address - Fax:810-720-8204
Practice Address - Street 1:G4007 W COURT ST
Practice Address - Street 2:SUITE.F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3560
Practice Address - Country:US
Practice Address - Phone:810-732-8120
Practice Address - Fax:810-720-8204
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301059876208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4177725Medicaid
MI0989672OtherHEALTHPLUS
MI05025021-92OtherBCBSM
MI4301059876OtherLICENSE
MI0989672OtherHEALTHPLUS
ON21360Medicare ID - Type Unspecified