Provider Demographics
NPI:1841469046
Name:RAO, SUMA P (MD)
Entity type:Individual
Prefix:
First Name:SUMA
Middle Name:P
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 1:901 E WILLETTA ST STE 2503
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2727
Mailing Address - Country:US
Mailing Address - Phone:602-839-5166
Mailing Address - Fax:
Practice Address - Street 1:901 E WILLETTA ST STE 2503
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2727
Practice Address - Country:US
Practice Address - Phone:602-839-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ405352080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine