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NPI Code Detail

MEDICARE: JYON RAO MD

MEDICARE:   JYON  RAO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0000XAdolescent Medicine (Family Medicine) Physician0101024421VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10101024421OTHERVALIC

General Provider Information

NPI Number : 1811997471
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYON RAO MD
Provider Business Mailing Address
First Line : 1147 INDEPENDENCE BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-5545
Country : US
Telephone Number : 757-460-1207
Fax Number : 757-460-2135
Provider Business Practice Location Address
First Line : 1147 INDEPENDENCE BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-5545
Country : US
Telephone Number : 757-460-1207
Fax Number : 757-460-2135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 03/07/2023

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