Individual
DR. GAYATHRI SUDHAKAR RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
599 ARCOLA RD, NEMOURS DUPONT PEDIATRICS, COLLEGEVILLE, COLLEGEVILLE, PA 19426-3954
(302) 651-6660
(302) 651-5345
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD040876E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10934628
—
PA
01
—
232359401
MAIN LINE HEALTHCARE
PA
Enumeration date
02/06/2006
Last updated
11/05/2015
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