Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | LT000798 | PA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD469099 | PA |
NPI | 1144736620 |
---|---|
Provider Name | Sriram Rao |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2017 |
Last Update Date | 30/12/2019 |