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Individual

DR. KONDRAGANTI P RAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
28111 HOOVER, WARREN, MI 48093
(586) 573-0589
(586) 573-3861
Mailing address
50 N DEEPLANDS ROAD, GROSSE POINTE SHORES, MI 48236
(586) 573-0589
(586) 573-3861

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301032931
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301032931
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2627454
MI
Enumeration date
03/14/2006
Last updated
11/02/2023
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