Individual
SAJAN KUCHIPUDI RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 9TH ST N, STE 104, NAPLES, FL 34102-8143
(239) 963-9788
(239) 963-9771
Mailing address
625 9TH ST N, STE 104, NAPLES, FL 34102-8143
(239) 963-9788
(239) 963-9771
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD034810
DC
207RC0000X
Cardiovascular Disease Physician
034810
DC
207RC0000X
Cardiovascular Disease Physician
Primary
ME103253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039095800
—
DC
05
—
1851589162
—
VA
05
—
4135342 00
—
MD
01
—
P00616347
RAILROAD MEDICARE
DC
Enumeration date
10/11/2007
Last updated
08/27/2021
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