Provider Demographics
NPI:1639142813
Name:RAO, YASHODA DHRUVA (MD)
Entity type:Individual
Prefix:
First Name:YASHODA
Middle Name:DHRUVA
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2324
Mailing Address - Country:US
Mailing Address - Phone:610-272-8221
Mailing Address - Fax:610-272-5655
Practice Address - Street 1:2901 JOLLY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2324
Practice Address - Country:US
Practice Address - Phone:610-272-8221
Practice Address - Fax:610-272-5655
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044932E207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01941401OtherKEYSTONE
PA116993900OtherFEDERAL EMPLOYEES COMP
PA0473231OtherUS HEALTHCARE
PA0998130OtherKEYSTONE SPECIALIST
PA38786OtherGEISINGER HEALTH PLAN
PA0000583466OtherBLUE SHIELD
PA0011884020001Medicaid
PA110031034OtherRAILROAD MEDICARE PBA
PA50047347OtherCAPITAL BLUE CROSS
PA020301000OtherFEDERAL BLACK LUNG
PA50047347OtherCAPITAL BLUE CROSS
PA0011884020001Medicaid