MEDICARE: MS. MORGINA JULIETTE RAO PA-C

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	363AM0700X	Medical Physician Assistant	PA10003563	WA
2	363AM0700X	Medical Physician Assistant	C0001559	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C0001559	OTHER	MD	MARYLAND PA LICENSE

General Provider Information

NPI Number	:	1730200122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MORGINA JULIETTE RAO PA-C

Provider Business Mailing Address
First Line	:	9200 EDWARDS WAY APT 209
Second Line	:
City	:	ADELPHI
State	:	MD
Zip	:	20783-3455
Country	:	US
Telephone Number	:	240-423-3729
Fax Number	:

Provider Business Practice Location Address
First Line	:	10750 COLUMBIA PIKE STE 401
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-593-6072
Fax Number	:	866-382-1197

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/09/2021

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