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General NPI Number Information
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NPI Number | 1235128109
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Entity Type | Individual
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Provider Name | KRISHNA A RAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 415 N 9TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62702-5317
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Country | US
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Telephone | 217-545-5817
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Fax | 217-545-7021
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Provider Business Mailing Address
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Address Line | PO BOX 19639
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9639
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Country | US
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Telephone | 217-545-7578
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Fax | 217-545-1884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | IL
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