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PANDURANGA S RAO MB, BS
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1326120247
Individual Registrant: PANDURANGA S RAO MB, BS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1500 EAST MEDICAL CENTER DR 3RD FLOOR TAUBMAN CTR RECP C ANN ARBOR, MA 48109-5364 US
Tel: 734-936-5548 Fax: --
Tel: 734-936-5548 Fax: --
Contact information for business:
3621 S STATE ST 700 KMS PLACE ANN ARBOR, MI 48108 US
Tel: 734-936-2047 Fax: --
Tel: 734-936-2047 Fax: --
Registration Information:
NPI: 1326120247
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | MI | 4301082768 |
| Y | 207RN0300X | Allopathic & Osteopathic Physicians Internal Medicine | MI | 4301082768 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 4550920 | MI | 05 |
