Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301088509 | MI |
NPI | 1336360197 |
---|---|
Provider Name | Dr. Sandeep Sambrani Rao |
First Address | Midland, MI 48640-6112 |
Second Address | Midland, MI 48640-6112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 07/09/2012 |