Healthcare Provider Details

I. General information

NPI: 1700886546
Provider Name (Legal Business Name): RAO KILARU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 DARROW RD STE 106 UNIVERSITY EMERGENCY SPECIALISTS INC
HUDSON OH
44236-5026
US

IV. Provider business mailing address

5700 DARROW RD SUITE 106 UNIVERSITY EMERGENCY SPECIALISTS
HUDSON OH
44236
US

V. Phone/Fax

Practice location:
  • Phone: 815-272-7085
  • Fax: 330-656-5901
Mailing address:
  • Phone: 815-272-7085
  • Fax: 330-656-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number36.12180
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: