Individual
SUDEEP NARAYANA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
831 HILLCREST RD STE C, MOBILE, AL 36695-4075
(251) 633-4949
(251) 633-4363
Mailing address
1700 SPRING HILL AVE STE 100, MOBILE, AL 36604-1416
(251) 435-1200
(251) 435-6357
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24971
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910919
—
AL
05
—
009938446
—
AL
05
—
009938447
—
AL
05
—
01237334
—
MS
01
—
51536200
BCBS - STANTON RD
AL
01
—
51536282
BCBS - FILLINGIM ST
AL
01
—
51542496
BCBS - MEDICAL PARK FOUR
AL
Enumeration date
07/26/2006
Last updated
07/17/2020
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