Healthcare Provider Details

I. General information

NPI: 1649258856
Provider Name (Legal Business Name): SAMEENA J. RAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMEENA J. AHMED M.D.

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11380 ILLINOIS ST
CARMEL IN
46032-9840
US

IV. Provider business mailing address

679 E COUNTY LINE RD
GREENWOOD IN
46143-1049
US

V. Phone/Fax

Practice location:
  • Phone: 877-362-2778
  • Fax:
Mailing address:
  • Phone: 317-807-1262
  • Fax: 317-859-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number01068871A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number220907
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: