Provider Demographics
NPI:1295968600
Name:RAO, QASIM ALI (MD)
Entity type:Individual
Prefix:
First Name:QASIM
Middle Name:ALI
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 BEN BOLT AVE
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24651-5386
Mailing Address - Country:US
Mailing Address - Phone:276-988-8730
Mailing Address - Fax:276-988-0563
Practice Address - Street 1:388 BEN BOLT AVE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-5386
Practice Address - Country:US
Practice Address - Phone:276-988-8730
Practice Address - Fax:276-988-0563
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3215812085R0202X
WV247222085R0202X
VA01012486042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherRAILROAD MEDICARE
WVPENDINGMedicaid
VAPENDINGMedicaid
WVPENDINGMedicare PIN