Individual
DR. PRABAKAR KUMAR RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FOREST PARK AVE, DEPT OPHTHALMOLOGY, 6TH FL, SAINT LOUIS, MO 63108-1495
(314) 362-3937
(314) 362-3725
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-3937
(314) 362-3725
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
118703
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204824817
—
MO
Enumeration date
08/12/2005
Last updated
04/17/2025
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