Individual
DR. INNANJE RAVINDRANATH RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1423 E FRANKLIN ST, SUITE B, MONROE, NC 28112-5266
(704) 283-6953
(704) 283-0228
Mailing address
PO BOX 60122, CHARLOTTE, NC 28260-0122
(704) 512-4808
(704) 512-4838
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
19943
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267168
—
SC
01
—
70415
BCBS
NC
05
—
8970415
—
NC
01
—
P00612312
RAILROAD MEDICARE
NC
Enumeration date
06/14/2006
Last updated
07/20/2009
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