Provider Demographics
NPI:1659481661
Name:RAMA RAO, ANIL PRASAD (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:PRASAD
Last Name:RAMA RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANIL
Other - Middle Name:R
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3987 E PARADISE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6692
Mailing Address - Country:US
Mailing Address - Phone:520-400-9936
Mailing Address - Fax:520-365-0226
Practice Address - Street 1:7155 N MERCER SPRING PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1417
Practice Address - Country:US
Practice Address - Phone:520-298-5454
Practice Address - Fax:520-296-6224
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29468207ZP0102X
WI2703-320207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ595431Medicaid
MN417016Medicare UPIN