Individual
CHINTAMENI B RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 LAKE SHORE DR, ISHPEMING, MI 49849-1367
(906) 485-2668
(906) 485-5676
Mailing address
2837 US 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
(906) 226-3875
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301039874
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356473
—
MI
01
—
3505221052
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
02/27/2006
Last updated
01/23/2014
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