MEDICARE: DR. DURGA E RAO M.D.

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	207RN0300X	Nephrology Physician	206923	MA
2	207RN0300X	Nephrology Physician	11070	NH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
16	P00357410	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1160076	OTHER	MA	FALLON
2	206293	OTHER	MA	TUFTS HEALTH PLAN
3	7689347	OTHER	MA	AETNA
4	AA113088	OTHER	NH	HARVARD NH
5	AA107182	OTHER	MA	HARVARD PILGRIM
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	J23160	OTHER	MA	BLUE CROSS BLUE SHIELD
9	0022002	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
10	01Y007131NH05	OTHER	NH	ANTHEM NH
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	975142	OTHER	MA	NETWORK HEALTH
13	01YP07131MA01	OTHER	NH	ANTHEM BS
14	31-00829	OTHER	MA	EVERCARE
15	3616343	OTHER		CIGNA

General Provider Information

NPI Number	:	1770554370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DURGA E RAO M.D.

Provider Business Mailing Address
First Line	:	411 MERRIMACK ST
Second Line	:	SUITE 204
City	:	METHUEN
State	:	MA
Zip	:	01844-5821
Country	:	US
Telephone Number	:	978-689-2500
Fax Number	:	978-689-2502

Provider Business Practice Location Address
First Line	:	411 MERRIMACK ST
Second Line	:	SUITE 204
City	:	METHUEN
State	:	MA
Zip	:	01844-5821
Country	:	US
Telephone Number	:	978-689-2500
Fax Number	:	978-689-2502

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	09/09/2008

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