Provider Demographics
NPI:1154594133
Name:RAO, SWATHI (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SWATHI
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12430 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7645
Mailing Address - Country:US
Mailing Address - Phone:317-938-4559
Mailing Address - Fax:
Practice Address - Street 1:205 E CARMEL DR
Practice Address - Street 2:SUITE E
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2606
Practice Address - Country:US
Practice Address - Phone:317-663-7123
Practice Address - Fax:317-587-0496
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000636A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INPENDINGMedicare PIN