Healthcare Provider Details

I. General information

NPI: 1780690826
Provider Name (Legal Business Name): SUDHIR BALKRISHNA RAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 LINDEN ST SUITE 2
BIG RAPIDS MI
49307-1879
US

IV. Provider business mailing address

630 NOVAK LN
BIG RAPIDS MI
49307-2532
US

V. Phone/Fax

Practice location:
  • Phone: 231-796-6721
  • Fax: 231-796-1080
Mailing address:
  • Phone: 231-796-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301053731
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number4301053731
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: