Healthcare Provider Details

I. General information

NPI: 1659481661
Provider Name (Legal Business Name): ANIL PRASAD RAMA RAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANIL R. PRASAD M.D.

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7155 N MERCER SPRING PL
TUCSON AZ
85718-1417
US

IV. Provider business mailing address

7155 N MERCER SPRING PL
TUCSON AZ
85718-1417
US

V. Phone/Fax

Practice location:
  • Phone: 520-400-9936
  • Fax:
Mailing address:
  • Phone: 520-400-9936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number2703-320
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number29468
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: