Provider Demographics
NPI:1356336150
Name:RAO, RAMA JASTY (MD)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:JASTY
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 CHERRY ST
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2673
Mailing Address - Country:US
Mailing Address - Phone:419-251-8210
Mailing Address - Fax:419-251-7700
Practice Address - Street 1:2222 CHERRY ST
Practice Address - Street 2:SUITE 2800
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2673
Practice Address - Country:US
Practice Address - Phone:419-251-8210
Practice Address - Fax:419-251-7700
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301054019208000000X, 2080P0207X
OH350702782080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0146685Medicaid
OH0146685Medicaid
OH0802567Medicare PIN
MI0H16103400Medicare PIN
MI0H16103400Medicare PIN