Provider Demographics
NPI:1922039502
Name:RAO, MAHESWAR M (MD)
Entity type:Individual
Prefix:
First Name:MAHESWAR
Middle Name:M
Last Name:RAO
Suffix:
Gender:M
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:PO BOX 13169
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-0037
Mailing Address - Country:US
Mailing Address - Phone:520-296-1206
Mailing Address - Fax:520-296-7410
Practice Address - Street 1:1600 W CHANDLER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6100
Practice Address - Country:US
Practice Address - Phone:520-296-1206
Practice Address - Fax:520-296-7410
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ19473207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ256968Medicaid
AZP00175435OtherRAILROAD MEDICARE
AZE31343Medicare UPIN
AZP00175435OtherRAILROAD MEDICARE