Provider Demographics
NPI:1477760403
Name:RAO, KUMUDINI (MD)
Entity type:Individual
Prefix:
First Name:KUMUDINI
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KUMUDINI
Other - Middle Name:
Other - Last Name:VARDHINENI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3912 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4246
Mailing Address - Country:US
Mailing Address - Phone:717-761-8740
Mailing Address - Fax:717-761-8792
Practice Address - Street 1:3912 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4246
Practice Address - Country:US
Practice Address - Phone:717-761-8740
Practice Address - Fax:717-761-8792
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD451045207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program