1710274188 NPI number — DR. VEMULKONDA KONETI RAO MD

Table of content: DR. VEMULKONDA KONETI RAO MD (NPI 1710274188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710274188 NPI number — DR. VEMULKONDA KONETI RAO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAO
Provider First Name:
VEMULKONDA
Provider Middle Name:
KONETI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAO
Provider Other First Name:
V KONETI
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1710274188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LCID NIAID NIH RM 11N234 ALPS UNIT BLDG 10
Provider Second Line Business Mailing Address:
10, CENTER DRIVE
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20892-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-496-6502
Provider Business Mailing Address Fax Number:
301-496-7383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LCID NIAID NIH RM 11N234 BLDG 10
Provider Second Line Business Practice Location Address:
10, CENTER DRIVE
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20892-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-496-6502
Provider Business Practice Location Address Fax Number:
301-496-7383
Provider Enumeration Date:
07/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X , with the licence number:  D0060097 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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