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Individual

DR. SUJATHA ANASAPURAPU RAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3255 CINNEBAR PT STE 1, CARBONDALE, IL 62901-5203
(618) 303-2712
Mailing address
3255 CINNEBAR PT, CARBONDALE, IL 62901-5203
(618) 303-2712

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
201307515
IL
207RH0000X
Hematology (Internal Medicine) Physician
036111928
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036111928
IL
Enumeration date
11/02/2006
Last updated
01/07/2025
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