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General NPI Number Information
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NPI Number | 1497073514
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Entity Type | Individual
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Provider Name | SOWMYA RAO PA
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 469-450-0079
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Fax |
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Provider Business Mailing Address
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Address Line | 230 EATON RIDGE DR APT 104
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City | SAGAMORE HILLS
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State | OH
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Zip | 44067-4511
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Country | US
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Telephone | 469-450-0079
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5047
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06752
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License Number State | TX
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