MEDICARE: SHOBA 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	207Q00000X	Family Medicine Physician	35080771R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336147750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHOBA RAO MD

Provider Business Mailing Address
First Line	:	424 WARDS CORNER RD STE 200
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-6966
Country	:	US
Telephone Number	:	513-707-4041
Fax Number	:	513-576-1020

Provider Business Practice Location Address
First Line	:	2055 HOSPITAL DR STE 130
Second Line	:
City	:	BATAVIA
State	:	OH
Zip	:	45103-1978
Country	:	US
Telephone Number	:	513-732-0870
Fax Number	:	513-732-0873

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

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	05/08/2025

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Directions to “ SHOBA RAO MD” Practice Location

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