Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 220907 | MA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 01068871A | IN |
NPI | 1649258856 |
---|---|
Provider Name | Sameena J. Rao |
First Address | Greenwood, IN 46143-1049 |
Second Address | Indianapolis, IN 46260-1986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000691865 | ANTHEM PIN (01) | IN |
1487680518 | GROUP NPI (01) | IN |
201008000 | (05) | IN |
2088665 | (05) | MA |
I17201 | (02) | MA |