Individual
CORINNE SUNDAR RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 NW R D MIZE RD STE 206, BLUE SPRINGS, MO 64014-2513
(816) 655-5403
(816) 655-5257
Mailing address
120 HOSPITAL DR, LEBANON, MO 65536
(417) 533-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
106490
MO
208M00000X
Hospitalist Physician
Primary
106490
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008013557
MEDICARE PTAN
MO
01
—
106490
LICENSE
MO
05
—
205212608
—
MO
01
—
P00244830
RAILROAD MEDICARE
MO
Enumeration date
08/31/2005
Last updated
12/27/2024
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