Individual
SHAKUNTALA B RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301037359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1896780
—
MI
05
—
1896799
—
MI
01
—
300020499
RAILROAD MEDICARE
MI
Enumeration date
07/03/2006
Last updated
02/05/2014
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