Provider Demographics
NPI:1649258856
Name:RAO, SAMEENA J (MD)
Entity type:Individual
Prefix:
First Name:SAMEENA
Middle Name:J
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMEENA
Other - Middle Name:J
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:679 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-807-1262
Mailing Address - Fax:317-859-4268
Practice Address - Street 1:8240 NAAB RD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1986
Practice Address - Country:US
Practice Address - Phone:317-876-2330
Practice Address - Fax:317-876-2320
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220907207V00000X
IN01068871A207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000691865OtherANTHEM PIN
IN1487680518OtherGROUP NPI
IN201008000Medicaid
MA2088665Medicaid
MA2088665Medicaid
IN1487680518OtherGROUP NPI
MAA37658Medicare PIN