Immaneni, Rao Prasad

Immaneni, Rao Prasad is an sole proprietor health care provider with primary practice located at 1230 Brampton Ave , Statesboro GA 30458-0849. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Immaneni, Rao Prasad can be contacted via phone (912) 489-5437.

Contact Information

Primary practice address
1230 Brampton Ave Statesboro GA 30458-0849
Phone: (912) 489-5437
Fax: (912) 489-5550
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 044756 Georgia

Profile Details

NPI number 1720196520
LBN Legal business name Immaneni, Rao Prasad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2006
Last updated May 11th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720196520 NPPES
Georgia Other 000798377A PEACH STATE ID
Georgia Other 2263921 PEACH STATE ID
Georgia Other 598970 PEACH STATE ID
Georgia Other 1917290 PEACH STATE ID
Georgia Other 5261615 PEACH STATE ID
Georgia Other 0007241193 PEACH STATE ID
Georgia MEDICAID 000798377A PEACH STATE ID
Georgia Other 10057735 PEACH STATE ID
Georgia Other 336225 PEACH STATE ID

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