Healthcare Provider Details

I. General information

NPI: 1144268095
Provider Name (Legal Business Name): RAMA K RAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 JOHNSON FERRY RD STE 910
ATLANTA GA
30342-1626
US

IV. Provider business mailing address

759 OLD NORCROSS RD
LAWRENCEVILLE GA
30046-4317
US

V. Phone/Fax

Practice location:
  • Phone: 404-303-3750
  • Fax: 404-252-4755
Mailing address:
  • Phone: 404-300-2379
  • Fax: 404-300-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD424592
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number068605
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: