MEDICARE: ABNER O RAYAPATI MD LLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1437879541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABNER O RAYAPATI MD LLC

Provider Business Mailing Address
First Line	:	2220 EXECUTIVE DR STE 102
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-4871
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 EXECUTIVE DR STE 102
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-4871
Country	:	US
Telephone Number	:	859-737-0904
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	DAVID CARTER
Credential	:
Telephone Number	:	859-737-0904

Provider Enumeration Date	:	08/30/2022
Last Update Date	:	08/30/2022

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Directions to “ABNER O RAYAPATI MD LLC ” Practice Location

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