Provider Demographics
NPI:1427247196
Name:K S RAO MD PA
Entity type:Organization
Organization Name:K S RAO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARUPARTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-496-7700
Mailing Address - Street 1:5400 OLD COURT RD STE 108
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5125
Mailing Address - Country:US
Mailing Address - Phone:410-496-7700
Mailing Address - Fax:410-496-4070
Practice Address - Street 1:5400 OLD COURT RD STE 108
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5125
Practice Address - Country:US
Practice Address - Phone:410-496-7700
Practice Address - Fax:410-496-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J775OtherBSDC
DC1443OtherRRMC
888AKOtherBSMD
2039691OtherUNIT
2039691OtherUNIT
888AKOtherBSMD