Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 32276 | NC |
Y | 111NI0900X | Internist | 32276 | NC |
N | 207RG0300X | Geriatric Medicine | 32276 | NC |
NPI | 1063468809 |
---|---|
Provider Name | Lakshman Rao |
First Address | Erwin, NC 28339-2209 |
Second Address | Erwin, NC 28339-2209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 01/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C82360 | (02) | NC |