Individual
CHETHANA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3620 JOSEPH SIEWICK DR, SUITE 303, FAIRFAX, VA 22033-1756
(703) 870-3750
(703) 865-6784
Mailing address
3903 FAIR RIDGE DR, SUITE 218, FAIRFAX, VA 22033-2943
(703) 870-3750
(703) 594-8604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101235757
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010
CAREFIRST BCBS
—
01
—
0409727
EVERCARE
—
01
—
0409807
EVERCARE
—
01
—
1710917869
BCBS-VA
—
01
—
624762-01
BCBS
MD
Enumeration date
07/04/2006
Last updated
09/25/2014
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