Healthcare Provider Details

I. General information

NPI: 1437148855
Provider Name (Legal Business Name): VELUVOLU K RAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S 16TH ST ROOM 1000
MILWAUKEE WI
53215-4537
US

IV. Provider business mailing address

3201 S 16TH ST ROOM 1000
MILWAUKEE WI
53215-4537
US

V. Phone/Fax

Practice location:
  • Phone: 414-389-3180
  • Fax: 414-645-8240
Mailing address:
  • Phone: 414-389-3180
  • Fax: 414-645-8240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20251
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: