MEDICARE: CORINNE SUNDAR RAO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	106490	MO
2	208M00000X	Hospitalist Physician	106490	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00244830	OTHER	MO	RAILROAD MEDICARE
3	008013557	OTHER	MO	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	106490	OTHER	MO	LICENSE

General Provider Information

NPI Number	:	1255325643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNE SUNDAR RAO MD

Provider Business Mailing Address
First Line	:	120 HOSPITAL DR
Second Line	:
City	:	LEBANON
State	:	MO
Zip	:	65536
Country	:	US
Telephone Number	:	417-533-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 NW R D MIZE RD STE 206
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2513
Country	:	US
Telephone Number	:	816-655-5403
Fax Number	:	816-655-5257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	12/27/2024

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Directions to “ CORINNE SUNDAR RAO MD” Practice Location

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