Individual
MYTHRI R RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
33 W RAHN RD, KETTERING, OH 45429-2219
(937) 433-8990
(937) 433-8691
Mailing address
3589 QUEEN VICTORIA CT, BEAVERCREEK, OH 45431-5707
(937) 433-8990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35083513R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336870
BCBS
OH
01
—
000000574727
ANTHEM
OH
05
—
2448882
—
OH
01
—
P00138956
RAIL ROAD MEDICARE
—
Enumeration date
05/20/2006
Last updated
12/03/2009
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