Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 0101033243 | VA |
NPI | 1770632606 |
---|---|
Provider Name | Dr. Neerada Rao |
First Address | Potomac, MD 20854-4029 |
Second Address | Reston, VA 20190-3363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |